49422. (a) No physician, psychiatrist, oculist, dentist, dental
hygienist, optometrist, otologist, podiatrist, audiologist, or nurse
not employed in that capacity by the State Department of Health
Services, shall be, nor shall any other person be, employed or
permitted to supervise the health and physical development of pupils
unless he or she holds a services credential with a specialization in
health or a valid credential issued prior to the operative date of
Section 25 of Chapter 557 of the Statutes of 1990.
(b) Any psychologist employed pursuant to Section 49400 and this
article shall hold a school psychologist credential, a general pupil
personnel services credential authorizing service as a school
psychologist, a standard designated services credential with a
specialization in pupil personnel services authorizing service as a
psychologist, or a services credential issued by the State Board of
Education or Commission on Teacher Credentialing.
(c) The services credential with a specialization in health
authorizing service as a school nurse shall not authorize teaching
services unless the holder also completes the requirements for a
special class authorization in health in a program that is approved
by the commission.
(d) No physician employed by a district to perform medical
services pursuant to Section 44873, who meets the requirements of
that section, shall be required to hold a credential issued by the
State Board of Education or commission.
(e) (1) Notwithstanding Section 2910 of the Business and
Professions Code, no person who is an employee of a school district
shall administer psychological tests or engage in other psychological
activities involving the application of psychological principles,
methods, or procedures unless at least one of the following applies:
(A) The person holds a valid and current credential as a school
psychologist issued by the Commission on Teacher Credentialing that
permits the holder to administer psychological testing to, or engage
in psychological activities with, pupils.
(B) Psychological assistants or school psychology interns perform
the testing or activities under the supervision of a person who holds
a credential described in subparagraph (A).
(C) This section does not preclude appropriately credentialed
school personnel including, but not limited to, holders of a pupil
personnel services credential, health services credential, or special
education personnel, from performing the duties consistent with the
training standards established by the Commission on Teacher
Credentialing for the credential held.
(2) The application of these principles and methods includes, but
is not restricted to, procedures on interviewing, psychoeducational
assessment, diagnosis of specific learning and behavioral
disabilities, and amelioration of learning and behavioral problems of
individuals or groups.
(3) The person conducting a test or other assessment shall be
qualified in accordance with the requirements established by the
producer of the assessment instrument and shall follow all ethical
requirements for the use of the test or assessment as prescribed by
the appropriate professional organization.
(f) This section shall not be construed to affect any lawfully
contracted mental health professional licensed pursuant to Division 2
(commencing with Section 500) of the Business and Professions Code
from performing services within the scope of his or her employment.
49423. (a) Notwithstanding Section 49422, any pupil who is required
to take, during the regular schoolday, medication prescribed for him
or her by a physician and surgeon or ordered for him or her by a
physician assistant practicing in compliance with Chapter 7.7
(commencing with Section 3500) of Division 2 of the Business and
Professions Code, may be assisted by the school nurse or other
designated school personnel or may carry and self-administer
prescription auto-injectable epinephrine if the school district
receives the appropriate written statements identified in subdivision
(b).
(b) (1) In order for a pupil to be assisted by a school nurse or
other designated school personnel pursuant to subdivision (a), the
school district shall obtain both a written statement from the
physician and surgeon or physician assistant detailing the name of
the medication, method, amount, and time schedules by which the
medication is to be taken and a written statement from the parent,
foster parent, or guardian of the pupil indicating the desire that
the school district assist the pupil in the matters set forth in the
statement of the physician and surgeon or physician assistant.
(2) In order for a pupil to carry and self-administer prescription
auto-injectable epinephrine pursuant to subdivision (a), the school
district shall obtain both a written statement from the physician and
surgeon or physician assistant detailing the name of the medication,
method, amount, and time schedules by which the medication is to be
taken, and confirming that the pupil is able to self-administer
auto-injectable epinephrine, and a written statement from the parent,
foster parent, or guardian of the pupil consenting to the
self-administration, providing a release for the school nurse or
other designated school personnel to consult with the health care
provider of the pupil regarding any questions that may arise with
regard to the medication, and releasing the school district and
school personnel from civil liability if the self-administering pupil
suffers an adverse reaction as a result of self-administering
medication pursuant to this paragraph.
(3) The written statements specified in this subdivision shall be
provided at least annually and more frequently if the medication,
dosage, frequency of administration, or reason for administration
changes.
(c) A pupil may be subject to disciplinary action pursuant to
Section 48900 if that pupil uses auto-injectable epinephrine in a
manner other than as prescribed.
49423.1. (a) Notwithstanding Section 49422, any pupil who is
required to take, during the regular schoolday, medication prescribed
for him or her by a physician or surgeon, may be assisted by the
school nurse or other designated school personnel or may carry and
self-administer inhaled asthma medication if the school district
receives the appropriate written statements specified in subdivision
(b).
(b) (1) In order for a pupil to be assisted by a school nurse or
other designated school personnel pursuant to subdivision (a), the
school district shall obtain both a written statement from the
physician or surgeon detailing the name of the medication, method,
amount, and time schedules by which the medication is to be taken and
a written statement from the parent, foster parent, or guardian of
the pupil requesting that the school district assist the pupil in the
matters set forth in the statement of the physician or surgeon.
(2) In order for a pupil to carry and self-administer prescription
inhaled asthma medication pursuant to subdivision (a), the school
district shall obtain both a written statement from the physician or
surgeon detailing the name of the medication, method, amount, and
time schedules by which the medication is to be taken, and confirming
that the pupil is able to self-administer inhaled asthma medication,
and a written statement from the parent, foster parent, or guardian
of the pupil consenting to the self-administration, providing a
release for the school nurse or other designated school personnel to
consult with the health care provider of the pupil regarding any
questions that may arise with regard to the medication, and releasing
the school district and school personnel from civil liability if the
self-administering pupil suffers an adverse reaction by taking
medication pursuant to this section.
(3) The written statements specified in this subdivision shall be
provided at least annually and more frequently if the medication,
dosage, frequency of administration, or reason for administration
changes.
(c) A pupil may be subject to disciplinary action pursuant to
Section 48900 if that pupil uses inhaled asthma medication in a
manner other than as prescribed.
49423.5. (a) Notwithstanding Section 49422, an individual with
exceptional needs who requires specialized physical health care
services, during the regular schoolday, may be assisted by any of the
following individuals:
(1) Qualified persons who possess an appropriate credential issued
pursuant to Section 44267 or 44267.5, or hold a valid certificate of
public health nursing issued by the Board of Registered Nursing.
(2) Qualified designated school personnel trained in the
administration of specialized physical health care if they perform
those services under the supervision, as defined by Section 3051.12
of Title 5 of the California Code of Regulations, of a credentialed
school nurse, public health nurse, or licensed physician and surgeon
and the services are determined by the credentialed school nurse or
licensed physician and surgeon, in consultation with the physician
treating the pupil, to be all of the following:
(A) Routine for the pupil.
(B) Pose little potential harm for the pupil.
(C) Performed with predictable outcomes, as defined in the
individualized education program of the pupil.
(D) Do not require a nursing assessment, interpretation, or
decisionmaking by the designated school personnel.
(b) Specialized health care or other services that require
medically related training shall be provided pursuant to the
procedures prescribed by Section 49423.
(c) Persons providing specialized physical health care services
shall also demonstrate competence in basic cardiopulmonary
resuscitation and shall be knowledgeable of the emergency medical
resources available in the community in which the services are
performed.
(d) "Specialized physical health care services," as used in this
section, includes catheterization, gastric tube feeding, suctioning,
or other services that require medically related training.
(e) Regulations necessary to implement this section shall be
developed jointly by the State Department of Education and the State
Department of Health Care Services, and adopted by the state board.
(f) This section does not diminish or weaken any federal
requirement for serving individuals with exceptional needs under the
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et
seq.), and its implementing regulations, and under Section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. Sec. 794) and its implementing
regulations.
(g) This section does not affect current state law or regulation
regarding medication administration.
(h) It is the intent of the Legislature that this section not
cause individuals with exceptional needs to be placed at schoolsites
other than those they would attend but for their needs for
specialized physical health care services.
49423.5.1. On or before June 15, 2001, the State Department of
Education shall review and make recommendations to the State Board of
Education regarding any needed updates to the regulations adopted
pursuant to subdivision (e) of Section 49423.5.
49423.6. (a) On or before June 15, 2001, the State Department of
Education shall develop and recommend to the State Board of
Education, and the board shall adopt regulations, regarding the
administration of medication in the public schools pursuant to
Section 49423. These regulations shall be developed in consultation
with parents, representatives of the medical and nursing professions,
and other individuals jointly designated by the Superintendent of
Public Instruction, the Advisory Commission on Special Education
established pursuant to Section 33590, and the Department of Health
Services. The Board of Registered Nursing may designate a liaison to
consult with the Board of Education in the adoption of these
regulations.
(b) Any regulations adopted pursuant to this section shall be
limited to addressing a situation where a pupil's parent or legal
guardian has initiated a request to have a local educational agency
dispense medicine to a pupil, based on the written consent of the
pupil's parent or legal guardian, for a specified medicine with a
specified dosage, for a specified period of time, as prescribed by a
physician or other authorized medical personnel.
49424. A school psychologist is a credentialed professional whose
primary objective is the application of scientific principles of
learning and behavior to ameliorate school-related problems and to
facilitate the learning and development of children in the public
schools of California.
To accomplish this objective the school psychologist provides
services to children, teachers, parents, community agencies, and the
school system itself. These services include:
(a) Consultation with school administrators concerning appropriate
learning objectives for children, planning of developmental and
remedial programs for pupils in regular and special school programs,
and the development of educational experimentation and evaluation.
(b) Consultation with teachers in the development and
implementation of classroom methods and procedures designed to
facilitate pupil learning and to overcome learning and behavior
disorders.
(c) Consultation with parents to assist in understanding the
learning and adjustment processes of children.
(d) Consultation with community agencies, such as probation
departments, mental health clinics, and welfare departments,
concerning pupils who are being served by such community agencies.
(e) Consultation and supervision of pupil personnel services
workers.
(f) Psychoeducational assessment and diagnosis of specific
learning and behavioral disabilities, including, but not limited to,
case study evaluation, recommendations for remediation or placement,
and periodic reevaluation of such children.
(g) Psychological counseling of and other therapeutic techniques
with children and parents, including parent education.
49425. Notwithstanding the provisions of Section 49422, a licensed
physician need not hold a credential if his sole service for a school
district or county superintendent of schools is service as a member
of a committee whose function is to consider written and oral
information and reports concerning the pupil that are available to
the committee and, upon the basis of such information and reports, to
recommend the admission of the pupil to, or his discharge from,
special schools and classes for exceptional children.
49426. A school nurse is a registered nurse currently licensed
under Chapter 6 (commencing with Section 2700) of Division 2 of the
Business and Professions Code, and who has completed the additional
educational requirements for, and possesses a current credential in,
school nursing pursuant to Section 44877.
School nurses strengthen and facilitate the educational process by
improving and protecting the health status of children and by
identification and assistance in the removal or modification of
health-related barriers to learning in individual children. The major
focus of school health services is the prevention of illness and
disability, and the early detection and correction of health
problems. The school nurse is especially prepared and uniquely
qualified in preventive health, health assessment, and referral
procedures.
Nothing in this section shall be construed to limit the scope of
professional practice or otherwise to change the legal scope of
practice for any registered nurse or other licensed healing arts
practitioner. Rather, it is the intent of the Legislature to provide
positively for the health services, many of which may be performed in
the public schools only by physicians and school nurses. School
nurses may perform, if authorized by the local governing board, the
following services:
(a) Conduct immunization programs pursuant to Section 49403 and
assure that every pupil's immunization status is in compliance with
the law, including parental or guardian consent, and good health
practice.
(b) Assess and evaluate the health and developmental status of
pupils to identify specific physical disorders and other factors
relating to the learning process, communicate with the primary care
provider, and contribute significant information in order to modify
the pupils' educational plans.
(c) Interpret the health and developmental assessment to parents,
teachers, administrators, and other professionals directly concerned
with the pupil.
(d) Design and implement a health maintenance plan to meet the
individual health needs of the students, incorporating plans directed
by a physician.
(e) Refer the pupil and his or her parent or guardian to
appropriate community resources for necessary services.
(f) Maintain communication with parents and all involved community
practitioners and agencies to promote needed treatment and secure
reports of findings pertinent to educational planning.
(g) Interpret medical and nursing findings appropriate to the
student's individual educational plan and make recommendations to
professional personnel directly involved.
(h) Consult with, conduct in-service training to, and serve as a
resource person to teachers and administrators, and act as a
participant in implementing any section or sections of a
comprehensive health instruction curriculum for students by providing
current scientific information regarding nutrition, preventive
dentistry, mental health, genetics, prevention of communicable
diseases, self-health care, consumer education, and other areas of
health.
(i) Counsel pupils and parents by:
(1) Assisting children and youth, parents, and school personnel in
identifying and utilizing appropriate and mutually acceptable
private and community health delivery services for professional care
and remediation of defects.
(2) Counseling with parents, pupils and school staff regarding
health-related attendance problems.
(3) Helping parents, school personnel and pupils understand and
adjust to physical, mental and social limitations.
(4) Exploring with families and pupils, attitudes, information and
values which affect their health behavior.
(j) Assist parents and pupils to solve financial, transportation
and other barriers to needed health services.
The holder of a services credential with a specialization in
health for a school nurse who also completes the requirements for a
special class authorization in health in a program that is approved
by the commission is authorized to teach classes on health in a
preschool, kindergarten, grades 1 to 12, inclusive, and classes
organized primarily for adults.
49427. (a) It is the intent of the Legislature that the governing
board of each school district and each county superintendent of
schools maintain fundamental school health services at a level that
is adequate to accomplish all of the following:
(1) Preserve pupils' ability to learn.
(2) Fulfill existing state requirements and policies regarding
pupils' health.
(3) Contain health care costs through preventive programs and
education.
(b) The Legislature finds and declares that the provision of these
services may be in jeopardy due to the current caseloads in the
public schools, and that failure to maintain adequate health services
and standards will result in pupils' poorer health and ability to
learn.
49422. (a) No physician, psychiatrist, oculist, dentist, dental
hygienist, optometrist, otologist, podiatrist, audiologist, or nurse
not employed in that capacity by the State Department of Health
Services, shall be, nor shall any other person be, employed or
permitted to supervise the health and physical development of pupils
unless he or she holds a services credential with a specialization in
health or a valid credential issued prior to the operative date of
Section 25 of Chapter 557 of the Statutes of 1990.
(b) Any psychologist employed pursuant to Section 49400 and this
article shall hold a school psychologist credential, a general pupil
personnel services credential authorizing service as a school
psychologist, a standard designated services credential with a
specialization in pupil personnel services authorizing service as a
psychologist, or a services credential issued by the State Board of
Education or Commission on Teacher Credentialing.
(c) The services credential with a specialization in health
authorizing service as a school nurse shall not authorize teaching
services unless the holder also completes the requirements for a
special class authorization in health in a program that is approved
by the commission.
(d) No physician employed by a district to perform medical
services pursuant to Section 44873, who meets the requirements of
that section, shall be required to hold a credential issued by the
State Board of Education or commission.
(e) (1) Notwithstanding Section 2910 of the Business and
Professions Code, no person who is an employee of a school district
shall administer psychological tests or engage in other psychological
activities involving the application of psychological principles,
methods, or procedures unless at least one of the following applies:
(A) The person holds a valid and current credential as a school
psychologist issued by the Commission on Teacher Credentialing that
permits the holder to administer psychological testing to, or engage
in psychological activities with, pupils.
(B) Psychological assistants or school psychology interns perform
the testing or activities under the supervision of a person who holds
a credential described in subparagraph (A).
(C) This section does not preclude appropriately credentialed
school personnel including, but not limited to, holders of a pupil
personnel services credential, health services credential, or special
education personnel, from performing the duties consistent with the
training standards established by the Commission on Teacher
Credentialing for the credential held.
(2) The application of these principles and methods includes, but
is not restricted to, procedures on interviewing, psychoeducational
assessment, diagnosis of specific learning and behavioral
disabilities, and amelioration of learning and behavioral problems of
individuals or groups.
(3) The person conducting a test or other assessment shall be
qualified in accordance with the requirements established by the
producer of the assessment instrument and shall follow all ethical
requirements for the use of the test or assessment as prescribed by
the appropriate professional organization.
(f) This section shall not be construed to affect any lawfully
contracted mental health professional licensed pursuant to Division 2
(commencing with Section 500) of the Business and Professions Code
from performing services within the scope of his or her employment.
49423. (a) Notwithstanding Section 49422, any pupil who is required
to take, during the regular schoolday, medication prescribed for him
or her by a physician and surgeon or ordered for him or her by a
physician assistant practicing in compliance with Chapter 7.7
(commencing with Section 3500) of Division 2 of the Business and
Professions Code, may be assisted by the school nurse or other
designated school personnel or may carry and self-administer
prescription auto-injectable epinephrine if the school district
receives the appropriate written statements identified in subdivision
(b).
(b) (1) In order for a pupil to be assisted by a school nurse or
other designated school personnel pursuant to subdivision (a), the
school district shall obtain both a written statement from the
physician and surgeon or physician assistant detailing the name of
the medication, method, amount, and time schedules by which the
medication is to be taken and a written statement from the parent,
foster parent, or guardian of the pupil indicating the desire that
the school district assist the pupil in the matters set forth in the
statement of the physician and surgeon or physician assistant.
(2) In order for a pupil to carry and self-administer prescription
auto-injectable epinephrine pursuant to subdivision (a), the school
district shall obtain both a written statement from the physician and
surgeon or physician assistant detailing the name of the medication,
method, amount, and time schedules by which the medication is to be
taken, and confirming that the pupil is able to self-administer
auto-injectable epinephrine, and a written statement from the parent,
foster parent, or guardian of the pupil consenting to the
self-administration, providing a release for the school nurse or
other designated school personnel to consult with the health care
provider of the pupil regarding any questions that may arise with
regard to the medication, and releasing the school district and
school personnel from civil liability if the self-administering pupil
suffers an adverse reaction as a result of self-administering
medication pursuant to this paragraph.
(3) The written statements specified in this subdivision shall be
provided at least annually and more frequently if the medication,
dosage, frequency of administration, or reason for administration
changes.
(c) A pupil may be subject to disciplinary action pursuant to
Section 48900 if that pupil uses auto-injectable epinephrine in a
manner other than as prescribed.
49423.1. (a) Notwithstanding Section 49422, any pupil who is
required to take, during the regular schoolday, medication prescribed
for him or her by a physician or surgeon, may be assisted by the
school nurse or other designated school personnel or may carry and
self-administer inhaled asthma medication if the school district
receives the appropriate written statements specified in subdivision
(b).
(b) (1) In order for a pupil to be assisted by a school nurse or
other designated school personnel pursuant to subdivision (a), the
school district shall obtain both a written statement from the
physician or surgeon detailing the name of the medication, method,
amount, and time schedules by which the medication is to be taken and
a written statement from the parent, foster parent, or guardian of
the pupil requesting that the school district assist the pupil in the
matters set forth in the statement of the physician or surgeon.
(2) In order for a pupil to carry and self-administer prescription
inhaled asthma medication pursuant to subdivision (a), the school
district shall obtain both a written statement from the physician or
surgeon detailing the name of the medication, method, amount, and
time schedules by which the medication is to be taken, and confirming
that the pupil is able to self-administer inhaled asthma medication,
and a written statement from the parent, foster parent, or guardian
of the pupil consenting to the self-administration, providing a
release for the school nurse or other designated school personnel to
consult with the health care provider of the pupil regarding any
questions that may arise with regard to the medication, and releasing
the school district and school personnel from civil liability if the
self-administering pupil suffers an adverse reaction by taking
medication pursuant to this section.
(3) The written statements specified in this subdivision shall be
provided at least annually and more frequently if the medication,
dosage, frequency of administration, or reason for administration
changes.
(c) A pupil may be subject to disciplinary action pursuant to
Section 48900 if that pupil uses inhaled asthma medication in a
manner other than as prescribed.
49423.5. (a) Notwithstanding Section 49422, an individual with
exceptional needs who requires specialized physical health care
services, during the regular schoolday, may be assisted by any of the
following individuals:
(1) Qualified persons who possess an appropriate credential issued
pursuant to Section 44267 or 44267.5, or hold a valid certificate of
public health nursing issued by the Board of Registered Nursing.
(2) Qualified designated school personnel trained in the
administration of specialized physical health care if they perform
those services under the supervision, as defined by Section 3051.12
of Title 5 of the California Code of Regulations, of a credentialed
school nurse, public health nurse, or licensed physician and surgeon
and the services are determined by the credentialed school nurse or
licensed physician and surgeon, in consultation with the physician
treating the pupil, to be all of the following:
(A) Routine for the pupil.
(B) Pose little potential harm for the pupil.
(C) Performed with predictable outcomes, as defined in the
individualized education program of the pupil.
(D) Do not require a nursing assessment, interpretation, or
decisionmaking by the designated school personnel.
(b) Specialized health care or other services that require
medically related training shall be provided pursuant to the
procedures prescribed by Section 49423.
(c) Persons providing specialized physical health care services
shall also demonstrate competence in basic cardiopulmonary
resuscitation and shall be knowledgeable of the emergency medical
resources available in the community in which the services are
performed.
(d) "Specialized physical health care services," as used in this
section, includes catheterization, gastric tube feeding, suctioning,
or other services that require medically related training.
(e) Regulations necessary to implement this section shall be
developed jointly by the State Department of Education and the State
Department of Health Care Services, and adopted by the state board.
(f) This section does not diminish or weaken any federal
requirement for serving individuals with exceptional needs under the
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et
seq.), and its implementing regulations, and under Section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. Sec. 794) and its implementing
regulations.
(g) This section does not affect current state law or regulation
regarding medication administration.
(h) It is the intent of the Legislature that this section not
cause individuals with exceptional needs to be placed at schoolsites
other than those they would attend but for their needs for
specialized physical health care services.
49423.5.1. On or before June 15, 2001, the State Department of
Education shall review and make recommendations to the State Board of
Education regarding any needed updates to the regulations adopted
pursuant to subdivision (e) of Section 49423.5.
49423.6. (a) On or before June 15, 2001, the State Department of
Education shall develop and recommend to the State Board of
Education, and the board shall adopt regulations, regarding the
administration of medication in the public schools pursuant to
Section 49423. These regulations shall be developed in consultation
with parents, representatives of the medical and nursing professions,
and other individuals jointly designated by the Superintendent of
Public Instruction, the Advisory Commission on Special Education
established pursuant to Section 33590, and the Department of Health
Services. The Board of Registered Nursing may designate a liaison to
consult with the Board of Education in the adoption of these
regulations.
(b) Any regulations adopted pursuant to this section shall be
limited to addressing a situation where a pupil's parent or legal
guardian has initiated a request to have a local educational agency
dispense medicine to a pupil, based on the written consent of the
pupil's parent or legal guardian, for a specified medicine with a
specified dosage, for a specified period of time, as prescribed by a
physician or other authorized medical personnel.
49424. A school psychologist is a credentialed professional whose
primary objective is the application of scientific principles of
learning and behavior to ameliorate school-related problems and to
facilitate the learning and development of children in the public
schools of California.
To accomplish this objective the school psychologist provides
services to children, teachers, parents, community agencies, and the
school system itself. These services include:
(a) Consultation with school administrators concerning appropriate
learning objectives for children, planning of developmental and
remedial programs for pupils in regular and special school programs,
and the development of educational experimentation and evaluation.
(b) Consultation with teachers in the development and
implementation of classroom methods and procedures designed to
facilitate pupil learning and to overcome learning and behavior
disorders.
(c) Consultation with parents to assist in understanding the
learning and adjustment processes of children.
(d) Consultation with community agencies, such as probation
departments, mental health clinics, and welfare departments,
concerning pupils who are being served by such community agencies.
(e) Consultation and supervision of pupil personnel services
workers.
(f) Psychoeducational assessment and diagnosis of specific
learning and behavioral disabilities, including, but not limited to,
case study evaluation, recommendations for remediation or placement,
and periodic reevaluation of such children.
(g) Psychological counseling of and other therapeutic techniques
with children and parents, including parent education.
49425. Notwithstanding the provisions of Section 49422, a licensed
physician need not hold a credential if his sole service for a school
district or county superintendent of schools is service as a member
of a committee whose function is to consider written and oral
information and reports concerning the pupil that are available to
the committee and, upon the basis of such information and reports, to
recommend the admission of the pupil to, or his discharge from,
special schools and classes for exceptional children.
49426. A school nurse is a registered nurse currently licensed
under Chapter 6 (commencing with Section 2700) of Division 2 of the
Business and Professions Code, and who has completed the additional
educational requirements for, and possesses a current credential in,
school nursing pursuant to Section 44877.
School nurses strengthen and facilitate the educational process by
improving and protecting the health status of children and by
identification and assistance in the removal or modification of
health-related barriers to learning in individual children. The major
focus of school health services is the prevention of illness and
disability, and the early detection and correction of health
problems. The school nurse is especially prepared and uniquely
qualified in preventive health, health assessment, and referral
procedures.
Nothing in this section shall be construed to limit the scope of
professional practice or otherwise to change the legal scope of
practice for any registered nurse or other licensed healing arts
practitioner. Rather, it is the intent of the Legislature to provide
positively for the health services, many of which may be performed in
the public schools only by physicians and school nurses. School
nurses may perform, if authorized by the local governing board, the
following services:
(a) Conduct immunization programs pursuant to Section 49403 and
assure that every pupil's immunization status is in compliance with
the law, including parental or guardian consent, and good health
practice.
(b) Assess and evaluate the health and developmental status of
pupils to identify specific physical disorders and other factors
relating to the learning process, communicate with the primary care
provider, and contribute significant information in order to modify
the pupils' educational plans.
(c) Interpret the health and developmental assessment to parents,
teachers, administrators, and other professionals directly concerned
with the pupil.
(d) Design and implement a health maintenance plan to meet the
individual health needs of the students, incorporating plans directed
by a physician.
(e) Refer the pupil and his or her parent or guardian to
appropriate community resources for necessary services.
(f) Maintain communication with parents and all involved community
practitioners and agencies to promote needed treatment and secure
reports of findings pertinent to educational planning.
(g) Interpret medical and nursing findings appropriate to the
student's individual educational plan and make recommendations to
professional personnel directly involved.
(h) Consult with, conduct in-service training to, and serve as a
resource person to teachers and administrators, and act as a
participant in implementing any section or sections of a
comprehensive health instruction curriculum for students by providing
current scientific information regarding nutrition, preventive
dentistry, mental health, genetics, prevention of communicable
diseases, self-health care, consumer education, and other areas of
health.
(i) Counsel pupils and parents by:
(1) Assisting children and youth, parents, and school personnel in
identifying and utilizing appropriate and mutually acceptable
private and community health delivery services for professional care
and remediation of defects.
(2) Counseling with parents, pupils and school staff regarding
health-related attendance problems.
(3) Helping parents, school personnel and pupils understand and
adjust to physical, mental and social limitations.
(4) Exploring with families and pupils, attitudes, information and
values which affect their health behavior.
(j) Assist parents and pupils to solve financial, transportation
and other barriers to needed health services.
The holder of a services credential with a specialization in
health for a school nurse who also completes the requirements for a
special class authorization in health in a program that is approved
by the commission is authorized to teach classes on health in a
preschool, kindergarten, grades 1 to 12, inclusive, and classes
organized primarily for adults.
49427. (a) It is the intent of the Legislature that the governing
board of each school district and each county superintendent of
schools maintain fundamental school health services at a level that
is adequate to accomplish all of the following:
(1) Preserve pupils' ability to learn.
(2) Fulfill existing state requirements and policies regarding
pupils' health.
(3) Contain health care costs through preventive programs and
education.
(b) The Legislature finds and declares that the provision of these
services may be in jeopardy due to the current caseloads in the
public schools, and that failure to maintain adequate health services
and standards will result in pupils' poorer health and ability to
learn.
49422. (a) No physician, psychiatrist, oculist, dentist, dental
hygienist, optometrist, otologist, podiatrist, audiologist, or nurse
not employed in that capacity by the State Department of Health
Services, shall be, nor shall any other person be, employed or
permitted to supervise the health and physical development of pupils
unless he or she holds a services credential with a specialization in
health or a valid credential issued prior to the operative date of
Section 25 of Chapter 557 of the Statutes of 1990.
(b) Any psychologist employed pursuant to Section 49400 and this
article shall hold a school psychologist credential, a general pupil
personnel services credential authorizing service as a school
psychologist, a standard designated services credential with a
specialization in pupil personnel services authorizing service as a
psychologist, or a services credential issued by the State Board of
Education or Commission on Teacher Credentialing.
(c) The services credential with a specialization in health
authorizing service as a school nurse shall not authorize teaching
services unless the holder also completes the requirements for a
special class authorization in health in a program that is approved
by the commission.
(d) No physician employed by a district to perform medical
services pursuant to Section 44873, who meets the requirements of
that section, shall be required to hold a credential issued by the
State Board of Education or commission.
(e) (1) Notwithstanding Section 2910 of the Business and
Professions Code, no person who is an employee of a school district
shall administer psychological tests or engage in other psychological
activities involving the application of psychological principles,
methods, or procedures unless at least one of the following applies:
(A) The person holds a valid and current credential as a school
psychologist issued by the Commission on Teacher Credentialing that
permits the holder to administer psychological testing to, or engage
in psychological activities with, pupils.
(B) Psychological assistants or school psychology interns perform
the testing or activities under the supervision of a person who holds
a credential described in subparagraph (A).
(C) This section does not preclude appropriately credentialed
school personnel including, but not limited to, holders of a pupil
personnel services credential, health services credential, or special
education personnel, from performing the duties consistent with the
training standards established by the Commission on Teacher
Credentialing for the credential held.
(2) The application of these principles and methods includes, but
is not restricted to, procedures on interviewing, psychoeducational
assessment, diagnosis of specific learning and behavioral
disabilities, and amelioration of learning and behavioral problems of
individuals or groups.
(3) The person conducting a test or other assessment shall be
qualified in accordance with the requirements established by the
producer of the assessment instrument and shall follow all ethical
requirements for the use of the test or assessment as prescribed by
the appropriate professional organization.
(f) This section shall not be construed to affect any lawfully
contracted mental health professional licensed pursuant to Division 2
(commencing with Section 500) of the Business and Professions Code
from performing services within the scope of his or her employment.
49423. (a) Notwithstanding Section 49422, any pupil who is required
to take, during the regular schoolday, medication prescribed for him
or her by a physician and surgeon or ordered for him or her by a
physician assistant practicing in compliance with Chapter 7.7
(commencing with Section 3500) of Division 2 of the Business and
Professions Code, may be assisted by the school nurse or other
designated school personnel or may carry and self-administer
prescription auto-injectable epinephrine if the school district
receives the appropriate written statements identified in subdivision
(b).
(b) (1) In order for a pupil to be assisted by a school nurse or
other designated school personnel pursuant to subdivision (a), the
school district shall obtain both a written statement from the
physician and surgeon or physician assistant detailing the name of
the medication, method, amount, and time schedules by which the
medication is to be taken and a written statement from the parent,
foster parent, or guardian of the pupil indicating the desire that
the school district assist the pupil in the matters set forth in the
statement of the physician and surgeon or physician assistant.
(2) In order for a pupil to carry and self-administer prescription
auto-injectable epinephrine pursuant to subdivision (a), the school
district shall obtain both a written statement from the physician and
surgeon or physician assistant detailing the name of the medication,
method, amount, and time schedules by which the medication is to be
taken, and confirming that the pupil is able to self-administer
auto-injectable epinephrine, and a written statement from the parent,
foster parent, or guardian of the pupil consenting to the
self-administration, providing a release for the school nurse or
other designated school personnel to consult with the health care
provider of the pupil regarding any questions that may arise with
regard to the medication, and releasing the school district and
school personnel from civil liability if the self-administering pupil
suffers an adverse reaction as a result of self-administering
medication pursuant to this paragraph.
(3) The written statements specified in this subdivision shall be
provided at least annually and more frequently if the medication,
dosage, frequency of administration, or reason for administration
changes.
(c) A pupil may be subject to disciplinary action pursuant to
Section 48900 if that pupil uses auto-injectable epinephrine in a
manner other than as prescribed.
49423.1. (a) Notwithstanding Section 49422, any pupil who is
required to take, during the regular schoolday, medication prescribed
for him or her by a physician or surgeon, may be assisted by the
school nurse or other designated school personnel or may carry and
self-administer inhaled asthma medication if the school district
receives the appropriate written statements specified in subdivision
(b).
(b) (1) In order for a pupil to be assisted by a school nurse or
other designated school personnel pursuant to subdivision (a), the
school district shall obtain both a written statement from the
physician or surgeon detailing the name of the medication, method,
amount, and time schedules by which the medication is to be taken and
a written statement from the parent, foster parent, or guardian of
the pupil requesting that the school district assist the pupil in the
matters set forth in the statement of the physician or surgeon.
(2) In order for a pupil to carry and self-administer prescription
inhaled asthma medication pursuant to subdivision (a), the school
district shall obtain both a written statement from the physician or
surgeon detailing the name of the medication, method, amount, and
time schedules by which the medication is to be taken, and confirming
that the pupil is able to self-administer inhaled asthma medication,
and a written statement from the parent, foster parent, or guardian
of the pupil consenting to the self-administration, providing a
release for the school nurse or other designated school personnel to
consult with the health care provider of the pupil regarding any
questions that may arise with regard to the medication, and releasing
the school district and school personnel from civil liability if the
self-administering pupil suffers an adverse reaction by taking
medication pursuant to this section.
(3) The written statements specified in this subdivision shall be
provided at least annually and more frequently if the medication,
dosage, frequency of administration, or reason for administration
changes.
(c) A pupil may be subject to disciplinary action pursuant to
Section 48900 if that pupil uses inhaled asthma medication in a
manner other than as prescribed.
49423.5. (a) Notwithstanding Section 49422, an individual with
exceptional needs who requires specialized physical health care
services, during the regular schoolday, may be assisted by any of the
following individuals:
(1) Qualified persons who possess an appropriate credential issued
pursuant to Section 44267 or 44267.5, or hold a valid certificate of
public health nursing issued by the Board of Registered Nursing.
(2) Qualified designated school personnel trained in the
administration of specialized physical health care if they perform
those services under the supervision, as defined by Section 3051.12
of Title 5 of the California Code of Regulations, of a credentialed
school nurse, public health nurse, or licensed physician and surgeon
and the services are determined by the credentialed school nurse or
licensed physician and surgeon, in consultation with the physician
treating the pupil, to be all of the following:
(A) Routine for the pupil.
(B) Pose little potential harm for the pupil.
(C) Performed with predictable outcomes, as defined in the
individualized education program of the pupil.
(D) Do not require a nursing assessment, interpretation, or
decisionmaking by the designated school personnel.
(b) Specialized health care or other services that require
medically related training shall be provided pursuant to the
procedures prescribed by Section 49423.
(c) Persons providing specialized physical health care services
shall also demonstrate competence in basic cardiopulmonary
resuscitation and shall be knowledgeable of the emergency medical
resources available in the community in which the services are
performed.
(d) "Specialized physical health care services," as used in this
section, includes catheterization, gastric tube feeding, suctioning,
or other services that require medically related training.
(e) Regulations necessary to implement this section shall be
developed jointly by the State Department of Education and the State
Department of Health Care Services, and adopted by the state board.
(f) This section does not diminish or weaken any federal
requirement for serving individuals with exceptional needs under the
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et
seq.), and its implementing regulations, and under Section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. Sec. 794) and its implementing
regulations.
(g) This section does not affect current state law or regulation
regarding medication administration.
(h) It is the intent of the Legislature that this section not
cause individuals with exceptional needs to be placed at schoolsites
other than those they would attend but for their needs for
specialized physical health care services.
49423.5.1. On or before June 15, 2001, the State Department of
Education shall review and make recommendations to the State Board of
Education regarding any needed updates to the regulations adopted
pursuant to subdivision (e) of Section 49423.5.
49423.6. (a) On or before June 15, 2001, the State Department of
Education shall develop and recommend to the State Board of
Education, and the board shall adopt regulations, regarding the
administration of medication in the public schools pursuant to
Section 49423. These regulations shall be developed in consultation
with parents, representatives of the medical and nursing professions,
and other individuals jointly designated by the Superintendent of
Public Instruction, the Advisory Commission on Special Education
established pursuant to Section 33590, and the Department of Health
Services. The Board of Registered Nursing may designate a liaison to
consult with the Board of Education in the adoption of these
regulations.
(b) Any regulations adopted pursuant to this section shall be
limited to addressing a situation where a pupil's parent or legal
guardian has initiated a request to have a local educational agency
dispense medicine to a pupil, based on the written consent of the
pupil's parent or legal guardian, for a specified medicine with a
specified dosage, for a specified period of time, as prescribed by a
physician or other authorized medical personnel.
49424. A school psychologist is a credentialed professional whose
primary objective is the application of scientific principles of
learning and behavior to ameliorate school-related problems and to
facilitate the learning and development of children in the public
schools of California.
To accomplish this objective the school psychologist provides
services to children, teachers, parents, community agencies, and the
school system itself. These services include:
(a) Consultation with school administrators concerning appropriate
learning objectives for children, planning of developmental and
remedial programs for pupils in regular and special school programs,
and the development of educational experimentation and evaluation.
(b) Consultation with teachers in the development and
implementation of classroom methods and procedures designed to
facilitate pupil learning and to overcome learning and behavior
disorders.
(c) Consultation with parents to assist in understanding the
learning and adjustment processes of children.
(d) Consultation with community agencies, such as probation
departments, mental health clinics, and welfare departments,
concerning pupils who are being served by such community agencies.
(e) Consultation and supervision of pupil personnel services
workers.
(f) Psychoeducational assessment and diagnosis of specific
learning and behavioral disabilities, including, but not limited to,
case study evaluation, recommendations for remediation or placement,
and periodic reevaluation of such children.
(g) Psychological counseling of and other therapeutic techniques
with children and parents, including parent education.
49425. Notwithstanding the provisions of Section 49422, a licensed
physician need not hold a credential if his sole service for a school
district or county superintendent of schools is service as a member
of a committee whose function is to consider written and oral
information and reports concerning the pupil that are available to
the committee and, upon the basis of such information and reports, to
recommend the admission of the pupil to, or his discharge from,
special schools and classes for exceptional children.
49426. A school nurse is a registered nurse currently licensed
under Chapter 6 (commencing with Section 2700) of Division 2 of the
Business and Professions Code, and who has completed the additional
educational requirements for, and possesses a current credential in,
school nursing pursuant to Section 44877.
School nurses strengthen and facilitate the educational process by
improving and protecting the health status of children and by
identification and assistance in the removal or modification of
health-related barriers to learning in individual children. The major
focus of school health services is the prevention of illness and
disability, and the early detection and correction of health
problems. The school nurse is especially prepared and uniquely
qualified in preventive health, health assessment, and referral
procedures.
Nothing in this section shall be construed to limit the scope of
professional practice or otherwise to change the legal scope of
practice for any registered nurse or other licensed healing arts
practitioner. Rather, it is the intent of the Legislature to provide
positively for the health services, many of which may be performed in
the public schools only by physicians and school nurses. School
nurses may perform, if authorized by the local governing board, the
following services:
(a) Conduct immunization programs pursuant to Section 49403 and
assure that every pupil's immunization status is in compliance with
the law, including parental or guardian consent, and good health
practice.
(b) Assess and evaluate the health and developmental status of
pupils to identify specific physical disorders and other factors
relating to the learning process, communicate with the primary care
provider, and contribute significant information in order to modify
the pupils' educational plans.
(c) Interpret the health and developmental assessment to parents,
teachers, administrators, and other professionals directly concerned
with the pupil.
(d) Design and implement a health maintenance plan to meet the
individual health needs of the students, incorporating plans directed
by a physician.
(e) Refer the pupil and his or her parent or guardian to
appropriate community resources for necessary services.
(f) Maintain communication with parents and all involved community
practitioners and agencies to promote needed treatment and secure
reports of findings pertinent to educational planning.
(g) Interpret medical and nursing findings appropriate to the
student's individual educational plan and make recommendations to
professional personnel directly involved.
(h) Consult with, conduct in-service training to, and serve as a
resource person to teachers and administrators, and act as a
participant in implementing any section or sections of a
comprehensive health instruction curriculum for students by providing
current scientific information regarding nutrition, preventive
dentistry, mental health, genetics, prevention of communicable
diseases, self-health care, consumer education, and other areas of
health.
(i) Counsel pupils and parents by:
(1) Assisting children and youth, parents, and school personnel in
identifying and utilizing appropriate and mutually acceptable
private and community health delivery services for professional care
and remediation of defects.
(2) Counseling with parents, pupils and school staff regarding
health-related attendance problems.
(3) Helping parents, school personnel and pupils understand and
adjust to physical, mental and social limitations.
(4) Exploring with families and pupils, attitudes, information and
values which affect their health behavior.
(j) Assist parents and pupils to solve financial, transportation
and other barriers to needed health services.
The holder of a services credential with a specialization in
health for a school nurse who also completes the requirements for a
special class authorization in health in a program that is approved
by the commission is authorized to teach classes on health in a
preschool, kindergarten, grades 1 to 12, inclusive, and classes
organized primarily for adults.
49427. (a) It is the intent of the Legislature that the governing
board of each school district and each county superintendent of
schools maintain fundamental school health services at a level that
is adequate to accomplish all of the following:
(1) Preserve pupils' ability to learn.
(2) Fulfill existing state requirements and policies regarding
pupils' health.
(3) Contain health care costs through preventive programs and
education.
(b) The Legislature finds and declares that the provision of these
services may be in jeopardy due to the current caseloads in the
public schools, and that failure to maintain adequate health services
and standards will result in pupils' poorer health and ability to
learn.
