On August 30, 2022, PDE Bureau of Career and Technical Education Director Lee Burket, Ed.D. sent a Penn*Link Message to all LEAs titled Provision of Certified School Nurse Services to Pennsylvania School Students. The memo is a reminder that all public school entities, including school districts, charter schools, area career-technical schools and intermediate units, are responsible to provide school health services, specifically nursing services provided by certified school nurses.
Section 1402(a.1) of the Public School Code (24 P.S. § 14-1402(a.1)) requires that every child of school age be provided with school nurse services. Pursuant to Section 1402(a.1), the number of pupils under the care of each school nurse must not exceed 1,500. Section 1410 (24 P.S. § 14-1410) provides that all school districts alone or jointly with other districts or joint school boards must employ one or more school nurses. Section 1402(a) provides that “[e]ach child of school age shall be given by methods established by the Advisory Health Board, (1) a vision test by a school nurse, medical technician or teacher, (2) a hearing test by a school nurse or medical technician, (3) a measurement of height and weight by a school nurse or teacher, who shall use the measurement to compute a child’s weight-for-height ratio, (4) tests for tuberculosis under medical supervision, and (5) such other tests as the Advisory Health Board may deem advisable to protect the health of the child. Vision tests shall be given at least annually and other tests at intervals established by the Advisory Health Board.”
Pennsylvania Department of Health (PDH) regulations (28 Pa. Code § 23.51) provide that “[a] child in private, parochial and public schools shall be provided with school nurse services in the school which the child attends.” 28 Pa. Code Chapter 23 lists required school health services and required school health personnel. These regulations may be accessed at: http://www.pacode.com/secure/data/028/chapter23/chap23toc.html.
Duties of school nurses must be those assigned by the school district or joint school board which are exclusively connected with medical and dental school health activities. (28 Pa. Code § 23.34) PDH determines the technical content of the school nurses’ duties.
School nurses must have the proper certification issued by PDE.(28 Pa. Code § 23.54) Chapter 49 of Title 22 of the Pennsylvania Code (22 Pa. Code § 49.1) defines an Educational Specialist as “[p]rofessional certified personnel whose primary responsibility is to render professional service other than classroom teachers, such as…[a] school nurse…”
Teachers and other professional personnel may not perform professional duties or services in the schools of this Commonwealth in any area for which they have not been properly certified or permitted. 22 Pa. Code § 49.11(b). An individual who holds a teaching certificate may teach but cannot concomitantly provide the school health services that are to be provided by a certified school nurse, even if that individual is a licensed health professional, including health occupations and protective services instructors.
Section 1410 of the School Code (24 P.S. § 14-1410), however, provides that “[a]ny school district alone or jointly with other districts or joint school boards may employ dental hygienists and such other technical and clerical personnel as are necessary to carry out the provisions of this article.” Section 1410 permits schools to employ a licensed registered nurse (RN) or a licensed practical nurse (LPN) to assist a certified school nurse. Although schools are permitted to enter into an agreement with a supplemental RN or LPN to assist a certified school nurse, a supplemental nurse may not be assigned a student case load.
With respect to emergencies, 28 Pa. Code 23.79 provides that “[s]chool nurses shall plan for first aid services and instruct personnel responsible for giving first aid.” In the event of an emergency, any trained individual at the scene may render appropriate first aid procedures, including CPR and AED, prior to the arrival of EMS.
Comprehensive career and technical centers (CTC) are required to have a full-time certified school nurse on staff. Part-time CTCs can meet this requirement in one of three ways: (1) Hire a certified school nurse; (2) Develop an agreement with the school district in which the CTC building is located for school health services; or (3) Hire an RN or LPN to provide first aid care and medications while serving as a supplemental school nurse under the supervision of one of the school district’s certified school nurse.
Further clarification can be found on PDE’s website at http://www.portal.state.pa.us/portal/server.pt/community/schools/14130/what%27s_new_with_school_health/556690.
Questions about 28 Pa. Code Chapter 23 may be directed to the Pennsylvania Department of Health Bureau of School Health at 717-787-2390. Questions about 22 Pa. Code Chapter 49 may be directed PDE’s Bureau of School Leadership and Teacher Quality at 717-787-3356.