MISSISSIPPI LEGISLATURE
2018 Regular Session
To: Public Health and Human Services
By: Representative Dixon
AN ACT TO REQUIRE THAT BEFORE A HEALTH CARE PROVIDER MAY PRESCRIBE ANY MEDICATION TO TREAT ADD OR ADHD IN A CHILD, THE PROVIDER MUST HAVE A SECOND OPINION FROM AN INDEPENDENT PROFESSIONAL WHO IS NOT AFFILIATED IN ANY MANNER WITH THE ENTITY PROVIDING THE INITIAL ASSESSMENT STATING THAT THE CHILD NEEDS OR WOULD BENEFIT FROM TAKING THE MEDICATION, AND PROVIDE INFORMATION AND COUNSELING TO THE PARENT OR GUARDIAN OF THE CHILD ABOUT THE ACTUAL AND POTENTIAL SIDE EFFECTS OF THE MEDICATION TO BE PRESCRIBED; TO PROHIBIT PUBLIC SCHOOL EMPLOYEES AND PUBLIC SCHOOL NURSES FROM ADMINISTERING TO ANY STUDENT AT THE SCHOOL ANY MEDICATIONS THAT ARE PRESCRIBED TO TREAT ADD OR ADHD; TO AMEND SECTIONS 37-14-3 AND 41-79-5, MISSISSIPPI CODE OF 1972, TO CONFORM TO THE PRECEDING PROVISIONS; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. Before a physician or other health care provider may prescribe any medication to treat, manage or control the symptoms of attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) in a child under the age of eighteen (18) years, the health care provider must:
(a) Have a written opinion from an independent physician, psychologist, advanced practice registered nurse, physician assistant, licensed certified social worker, licensed professional counselor, licensed behavior analyst, licensed psychiatrist, licensed certified mental health specialist or medical professional employed with the State Department of Health, provided that such professional is not affiliated in any manner with the entity providing the initial assessment, stating that, in the person's professional opinion, the child needs or would benefit from taking the medication for ADD or ADHD; and
(b) Provide information and counseling to the parent or guardian of the child about the actual and potential side effects of the medication to be prescribed for ADD or ADHD.
SECTION 2. No public school employee or public school nurse may administer to any student at the school any medications that are prescribed to treat, manage or control the symptoms of attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD).
SECTION 3. Section 37-14-3, Mississippi Code of 1972, is amended as follows:
37-14-3. (1) The State Department of Education is designated as the state agency responsible for the administration and supervision of the school nurse program as an education and wellness curriculum in the public schools of the State of Mississippi. The public school nurse program administered by the State Department of Education shall be known and may be cited as the "Mary Kirkpatrick Haskell-Mary Sprayberry Public School Nurse Program." It is the intent of the Legislature that all funds made available to the State Department of Education for the purpose of employing school nurses shall be administered by the State Department of Education.
(2) The State Department of Education, through the Office of Healthy Schools, shall develop standards, procedures and criteria for the public school nurse programs in Kindergarten through Grade 12. The Office of Healthy Schools of the State Department of Education shall assume the responsibility for promoting a statewide school nurse program designed to prepare local school districts to incorporate the school program into their local educational programs.
(3) From and after July 1, 2007, the School Nurse Intervention Program administered and funded by the State Department of Health shall be transferred to the Office of Healthy Schools of the State Department of Education. Any administrative personnel employed by the State Department of Health for the administration of school nurses under the School Nurse Intervention Program may be considered for employment by the Office of Healthy Schools of the State Department of Education for the purpose of coordinating the employment of school nurses in the school districts. Any administrative personnel formerly employed by the Partnership for a Healthy Mississippi, Inc., for the administration of school nurses in the public schools may be considered for employment by the Office of Healthy Schools of the State Department of Education for the purpose of coordinating the employment of school nurses in the school districts. All records and unexpended balances of accounts in the School Nurse Intervention Program relating to the employment of school nurses shall be transferred to the Office of Healthy Schools in the State Department of Education in accordance with the transfer of responsibility under this chapter.
(4) The nurses in the Mary Kirkpatrick Haskell-Mary Sprayberry Public School Nurse Program shall have the following specific responsibilities:
(a) Serve as the coordinator of the health services program and provide nursing care;
(b) Provide health education to students;
(c) Implement activities to promote health and prevent tobacco, alcohol and substance use and abuse;
(d) Identify health and safety concerns in the school environment and promote a nurturing social environment;
(e) Administer medications and help students manage their health problems, subject to the prohibitions in Section 2 of this act;
(f) Support healthy food services programs;
(g) Promote healthy physical education, sports policies and practices;
(h) Promote dropout prevention programs; and
(i) Participate in allied health programs to introduce students to health careers.
(5) The Office of Healthy Schools of the State Department of Education shall provide resources to all public school nurses so that those schools with school nurses will be prepared to provide health education in Mississippi schools and support the Mississippi Comprehensive Health Framework, Mississippi Physical Education Framework, Wellness Policy, coordinated approach to school health, and other resources required by the State Board of Education.
(6) In administering the Mary Kirkpatrick Haskell-Mary Sprayberry Public School Nurse Program, the Office of Healthy Schools of the State Department of Education shall perform the following duties:
(a) Execute any contracts, agreements or other documents with any governmental agency or any person, corporation, association, partnership or other organization or entity that are necessary to accomplish the purposes of this chapter;
(b) Receive grants or any other contributions made to the State Board of Education to be used for specific purposes related to the goals of this chapter;
(c) Submit to the State Auditor any financial records that are necessary for the Auditor to perform an annual audit of the commission as required by law;
(d) Adopt any rules or regulations that are necessary to carry out the purposes of this chapter;
(e) Develop criteria to measure the effectiveness of a school nurse;
(f) Communicate to superintendents and principals how to maximize the effectiveness of a public school nurse;
(g) Develop recommended salary structure for school districts to use when hiring a school nurse;
(h) Communicate to superintendents, principals and other appropriate school officials regarding the statutes and regulations prohibiting the use of tobacco by school personnel on school property and at school events, and to monitor the effectiveness of this ban;
(i) Implement policies to reduce unnecessary paperwork by public school nurses; and
(j) Take any other actions that are necessary to carry out the purposes of this chapter.
SECTION 4. Section 41-79-5, Mississippi Code of 1972, is amended as follows:
41-79-5. (1) There is * * * established within the State Department
of Health a school nurse intervention program, available to all public school
districts in the state.
(2) By the school year 1998-1999, each public school district shall have employed a school nurse, to be known as a Health Service Coordinator, pursuant to the school nurse intervention program prescribed under this section. The school nurse intervention program shall offer any of the following specific preventive services, and other additional services appropriate to each grade level and the age and maturity of the pupils:
(a) Reproductive health education and referral to prevent teen pregnancy and sexually transmitted diseases, which education shall include abstinence;
(b) Child abuse and neglect identification;
(c) Hearing and vision screening to detect problems which can lead to serious sensory losses and behavioral and academic problems;
(d) Alcohol, tobacco and drug abuse education to reduce abuse of these substances;
(e) Scoliosis screening to detect this condition so that costly and painful surgery and lifelong disability can be prevented;
(f) Coordination of services for handicapped children to ensure that these children receive appropriate medical assistance and are able to remain in public school;
(g) Nutrition education and counseling to prevent obesity and/or other eating disorders which may lead to life-threatening conditions, for example, hypertension;
(h) Early detection and treatment of head lice to prevent the spread of the parasite and to reduce absenteeism;
(i) Emergency treatment of injury and illness to include controlling bleeding, managing fractures, bruises or contusions and cardiopulmonary resuscitation (CPR);
(j) Applying appropriate theory as the basis for decision making in nursing practice;
(k) Establishing and maintaining a comprehensive school health program;
(l) Developing individualized health plans;
(m) Assessing, planning, implementing and evaluating programs and other school health activities, in collaboration with other professionals;
(n) Providing health education to assist students, families and groups to achieve optimal levels of wellness;
(o) Participating in peer review and other means of evaluation to assure quality of nursing care provided for students and assuming responsibility for continuing education and professional development for self while contributing to the professional growth of others;
(p) Participating with other key members of the community responsible for assessing, planning, implementing and evaluating school health services and community services that include the broad continuum or promotion of primary, secondary and tertiary prevention; and
(q) Contributing to nursing and school health through innovations in theory and practice and participation in research.
(3) Public school nurses shall be specifically prohibited from providing abortion counseling to any student or referring any student to abortion counseling or abortion clinics. Any violation of this subsection shall disqualify the school district employing such public school nurse from receiving any state administered funds under this section.
(4) * * * Public school nurses are subject
to the prohibitions in Section 2 of this act.
(5) Beginning with the 1997-1998 school year, to the extent that federal or state funds are available therefor and pursuant to appropriation therefor by the Legislature, in addition to the school nurse intervention program funds administered under subsection (4), the State Department of Health shall establish and implement a Prevention of Teen Pregnancy Pilot Program to be located in the public school districts with the highest numbers of teen pregnancies. The Teen Pregnancy Pilot Program shall provide the following education services directly through public school nurses in the pilot school districts: health education sessions in local schools, where contracted for or invited to provide, which target issues including reproductive health, teen pregnancy prevention and sexually transmitted diseases, including syphilis, HIV and AIDS. When these services are provided by a school nurse, training and counseling on abstinence shall be included.
(6) In addition to the school nurse intervention program funds administered under subsection (4) and the Teen Pregnancy Pilot Program funds administered under subsection (5), to the extent that federal or state funds are available therefor and pursuant to appropriation therefor by the Legislature, the State Department of Health shall establish and implement an Abstinence Education Pilot Program to provide abstinence education, mentoring, counseling and adult supervision to promote abstinence from sexual activity, with a focus on those groups which are most likely to bear children out of wedlock. Such abstinence education services shall be provided by the State Department of Health through its clinics, public health nurses, school nurses and through contracts with rural and community health centers in order to reach a larger number of targeted clients. For purposes of this subsection, the term "abstinence education" means an educational or motivational program which:
(a) Has as its exclusive purpose, teaching the social, psychological and health gains to be realized by abstaining from sexual activity;
(b) Teaches abstinence from sexual activity outside marriage as the expected standard for all school-age children;
(c) Teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases and other associated health problems;
(d) Teaches that a mutually faithful monogamous relationship in context of marriage is the expected standard of human sexual activity;
(e) Teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects;
(f) Teaches that bearing children out of wedlock is likely to have harmful consequences for the child, the child's parents and society;
(g) Teaches young people how to reject sexual advances and how alcohol and drug use increase vulnerability to sexual advances; and
(h) Teaches the importance of attaining self-sufficiency before engaging in sexual activity.
(7) Beginning with the 1998-1999 school year and pursuant to appropriation therefor by the Legislature, in addition to other funds allotted under the minimum education program, each school district shall be allotted an additional teacher unit per every one hundred (100) teacher units, for the purpose of employing qualified public school nurses in such school district, which in no event shall be less than one (1) teacher unit per school district, for such purpose. In the event the Legislature provides less funds than the total state funds needed for the public school nurse allotment, those school districts with fewer teacher units shall be the first funded for such purpose, to the extent of funds available.
(8) Prior to the 1998-1999 school year, nursing staff assigned to the program shall be employed through the local county health department and shall be subject to the supervision of the State Department of Health with input from local school officials. Local county health departments may contract with any comprehensive private primary health care facilities within their county to employ and utilize additional nursing staff. Beginning with the 1998-1999 school year, nursing staff assigned to the program shall be employed by the local school district and shall be designated as "health service coordinators," and shall be required to possess a bachelor's degree in nursing as a minimum qualification.
(9) Upon each student's enrollment, the parent or guardian shall be provided with information regarding the scope of the school nurse intervention program. The parent or guardian may provide the school administration with a written statement refusing all or any part of the nursing service. No child shall be required to undergo hearing and vision or scoliosis screening or any other physical examination or tests whose parent objects thereto on the grounds such screening, physical examination or tests are contrary to his sincerely held religious beliefs.
(10) A consent form for reproductive health education shall be sent to the parent or guardian of each student upon his enrollment. If a response from the parent or guardian is not received within seven (7) days after the consent form is sent, the school shall send a letter to the student's home notifying the parent or guardian of the consent form. If the parent or guardian fails to respond to the letter within ten (10) days after it is sent, then the school principal shall be authorized to allow the student to receive reproductive health education. Reproductive health education shall include the teaching of total abstinence from premarital sex and, wherever practicable, reproductive health education should be taught in classes divided according to gender. All materials used in the reproductive health education program shall be placed in a convenient and easily accessible location for parental inspection. School nurses shall not dispense birth control pills or contraceptive devices in the school. Dispensing of such shall be the responsibility of the State Department of Health on a referral basis only.
(11) No provision of this section shall be construed as prohibiting local school districts from accepting financial assistance of any type from the State of Mississippi or any other governmental entity, or any contribution, donation, gift, decree or bequest from any source which may be utilized for the maintenance or implementation of a school nurse intervention program in a public school system of this state.
SECTION 5. This act shall take effect and be in force from and after July 1, 2018.