2006 Regular Session
To: Education; Public Health and Human Services
By: Representative Holland
AN ACT TO CREATE A NEW SECTION TO BE CODIFIED AS SECTION 37-3-88, MISSISSIPPI CODE OF 1972, TO REQUIRE ALL PUBLIC SCHOOL STUDENTS ENTERING KINDERGARTEN AND GRADES 1 AND 3 TO DOCUMENT HAVING PASSED A RECENT VISION SCREENING, TO EXEMPT STUDENTS WHOSE VISION WILL BE SCREENED AT SCHOOL THAT YEAR THROUGH THE STATE STUDENT VISION SCREENING PROGRAM AND STUDENTS WHOSE PARENTS OBJECT TO SUCH SCREENING ON RELIGIOUS GROUNDS, TO REQUIRE STUDENTS WHO FAIL THE SCREENING TO HAVE A COMPREHENSIVE EYE EXAMINATION PERFORMED BY AN OPHTHALMOLOGIST OR OPTOMETRIST, TO REQUIRE THE EXAMINER TO SUBMIT A DETAILED REPORT OF THE EXAM TO THE SCHOOL NURSE, CHILD'S PARENTS AND CHILD'S PRIMARY HEALTH CARE PROVIDER, AND TO REQUIRE THE STATE SUPERINTENDENT OF PUBLIC EDUCATION TO ENFORCE THE REQUIREMENTS OF THIS SECTION; TO BRING FORWARD SECTION 37-3-87, MISSISSIPPI CODE OF 1972, WHICH ESTABLISHES A STUDENT VISION SCREENING PROGRAM UNDER THE STATE DEPARTMENT OF EDUCATION, AND SECTION 41-79-5, MISSISSIPPI CODE OF 1972, WHICH ESTABLISHES THE SCHOOL NURSE INTERVENTION PROGRAM WITHIN THE STATE DEPARTMENT OF HEALTH, FOR PURPOSES OF POSSIBLE AMENDMENT; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. The following shall be codified as Section 37-3-88, Mississippi Code of 1972:
37-3-88. (1) (a) Except as otherwise provided in paragraph (c) of this subsection, the parent, guardian or custodian of a child entering kindergarten in a public school in this state shall present to the school nurse, within thirty (30) calendar days of the child's enrollment, documentation evidencing that the child has passed an acceptable vision screening within the twelve (12) months preceding the child's entering kindergarten.
(b) Except as otherwise provided in paragraph (c) of this subsection, the parent, guardian or custodian of a child entering Grade 1 or Grade 3 in a public school in this state shall present to the school nurse, within thirty (30) calendar days of the child's enrollment, documentation evidencing that the child has passed an acceptable vision screening within the six (6) months preceding the child's entering that grade.
(c) Any child entering kindergarten or Grade 1 or Grade 3 to whom eye screening services will be provided during that school year as part of the student vision screening program established under Section 37-3-87 is not required to present documentation that the child has had a vision screening as required under paragraphs (a) and (b) of this subsection. If the parent, guardian or custodian of a child objects to a vision screening on the grounds that the screening is contrary to that person's sincerely held religious beliefs, documentation that the child has had a vision screening is not required.
(d) The State Department of Education shall prescribe standards for vision screening services that are not part of the student vision screening program established under Section 37-3-87. The standards must be as stringent as those, if any, adopted for the state student vision screening program and must include the minimum qualifications of screening service personnel. In order for vision screening services to be considered acceptable, as required under paragraphs (a) and (b) of this subsection, the provider of the services must meet the standards prescribed by the department.
(2) (a) If the results of a vision screening required under subsection (1) of this section identify a student as having vision or eye problems, the school shall require the student to have a comprehensive eye examination performed by an ophthalmologist or optometrist. The comprehensive eye examination must include the following:
(i) Measurement of visual acuity;
(ii) Ocular alignment and motility;
(iii) Depth perception--stereopsis;
(v) Slit lamp;
(vi) Examination of the anterior segment and pupils;
(vii) Cycloplegic refraction; and
(viii) Dilated fundus exam.
(b) An ophthalmologist or optometrist performing a comprehensive eye examination on a child in response to the results of the child's vision screening required under subsection (1) of this section shall forward a written report of the results of the eye examination to the school nurse and a copy of the report to the child's parent, guardian or custodian and the child's primary health care provider. The report must include, but not necessarily be limited to, the following:
(i) Date of report;
(ii) Name, address and date of birth of the child;
(iii) Name of the child's school;
(iv) Type of examination;
(v) A summary of significant findings, including diagnoses, medication used, duration of action of medication, treatment, prognosis, whether or not a return visit is recommended and if so, when;
(vi) Recommended educational adjustments for the child, if any, which may include preferential seating in the classroom, eyeglasses for full-time use in school, eyeglasses for part-time use in school, sight-saving eyeglasses or any other recommendations; and
(vii) Name, address and signature of the ophthalmologist or optometrist.
(3) A child required under subsection (1)(a) to present documentation evidencing that the child has had a vision screening may not be denied enrollment in kindergarten due to the failure of the child's parent, guardian or custodian to provide the required documentation or the failure of an examiner to furnish the results of the child's comprehensive eye examination as required under subsection (2). However, the school shall provide written notice to the child's parent, guardian or custodian of the vision screening requirement and shall encourage the parent, guardian or custodian to comply with the requirements of this section.
(4) The State Superintendent of Public Education is responsible for the enforcement of this section. Before January 1 of each year, the State Department of Education shall prepare and submit a report on the impact and effectiveness of this section to the Chairmen of the Education Committees of the House of Representatives and Senate.
SECTION 2. Section 37-3-87, Mississippi Code of 1972, is brought forward as follows:
37-3-87. (1) The State Department of Education is hereby authorized and empowered to establish a student vision screening program to make eye screening services available to students in Grades K-12 in the public schools in order to detect vision problems which can lead to academic problems. Such eye screening service shall be based on a process that is screening in nature, and not diagnostic, which is intended to identify with a reasonably high probability, students with a wide range of eye problems who should seek the services of an eye care professional for examination, diagnosis and corrective recommendation. Such eye screening service shall provide each student screened with a report of the student's screening results to be taken home. Each school shall be provided with a list of the students screened, and their results. Statistical summaries of the screening results shall be provided to each school, and composite statistics by school system, county or district shall be provided to the State Department of Education. The State Department of Education may contract with any legal entity to administer the student vision screening program on the school district level, and such contract shall be let on a competitive basis. State funding for said program shall only be available subject to appropriation by the Legislature.
(2) The school board of any local school district shall cooperate with the State Department of Education and any entity under contract with the department to implement the student vision screening program established under this section.
(3) Before September 1, 1996, an advisory committee for the student vision screening program comprised of six (6) eye care professionals shall be appointed. The Governor, Lieutenant Governor and Speaker of the House of Representatives each shall appoint one (1) member from a list of nominees submitted by the Mississippi Optometric Association and one (1) member from a list of nominees submitted by the Mississippi Eye, Ear, Nose and Throat Association, so that the advisory committee consists of three (3) representatives from each organization. The members of the committee shall serve for a term of four (4) years, to run concurrent with the term of the Governor after the expiration of the initial term.
In order to protect the health, safety and welfare of students as related to eye care, the advisory committee shall review the procedures, methodology and nature of the vision screening services offered under any contract entered into by the State Department of Education for the administration of the student vision screening program. Any advisory opinions adopted by the committee on the vision screening process may be submitted to the State Board of Education and the State Board of Health for consideration or any appropriate action.
The advisory committee shall determine the times and locations of its meetings. Members of the advisory committee shall serve without compensation.
SECTION 3. Section 41-79-5, Mississippi Code of 1972, is brought forward as follows:
41-79-5. (1) There is hereby 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.
(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 4. This act shall take effect and be in force from and after July 1, 2006.