††††† 702 KAR 1:160. School health services.


††††† RELATES TO: KRS 156.160(1)(g), (h), (i), 156.501, 156.502, 161.145, 214.034, 214.036, 29 C.F.R. 1910.1030

††††† STATUTORY AUTHORITY: KRS 156.070, 156.160(1)

††††† NECESSITY, FUNCTION, AND CONFORMITY: KRS 156.160(1)(g) requires the Kentucky Board of Education to promulgate administrative regulations governing medical inspection, physical and health education and recreation, and other administrative regulations deemed necessary or advisable for the protection of the physical welfare and safety of the public school children. KRS 156.160(1)(h) and (i) require the board to promulgate an administrative regulation governing a required vision examination and a dental screening or examination. This administrative regulation establishes standards and criteria for preventative health care examinations at the local school district level.


††††† Section 1. School Employee Medical Examinations. (1) Except as provided in subsection (2) of this section, a local board of education shall require a medical examination of each certified or classified employee, including each substitute teacher. The medical examination shall:

††††† (a) Be conducted prior to initial employment; and

††††† (b) Include a tuberculosis (TB) risk assessment.

††††† 1. If the individual is identified by that assessment as being at high risk for TB, the individual shall be required to undergo the administration of a tuberculin skin test (TST).

††††† 2. The TB risk assessment shall be performed and reported by a physician, an advanced practice registered nurse, a physicianís assistant, or a registered nurse.

††††† (2) The medical examination requirement shall not apply to school bus drivers who are covered by 702 KAR 5:080.

††††† (3) A local board of education may require by policy that a school employee physical examination be conducted no earlier than a ninety (90) day period prior to initial employment.

††††† (4) A medical examination shall be reported on the form Medical Examination of School Employees, KDESHS001.

††††† (5) A person who tests positive for TB shall be required to comply with the directives of the local board of health and the Kentucky Department for Public Health for further evaluation and treatment of the TB infection.

††††† (6)(a) Following the required medical examination for initial employment and any subsequent examinations as may be required for positive tuberculin reactors, a school district employee other than a bus driver shall submit to the local school superintendent the completed Medical Examination of School Employees from required by subsection (4) of this section.

††††† (b) The medical examination shall be performed and signed for by a physician, physician's assistant, or an advanced practice registered nurse.

††††† (7) Documentation of a TST and chest x-ray, if performed, shall include:

††††† (a) The date given;

††††† (b) Type of test;

††††† (c) Millimeters of induration;

††††† (d) Date read and by whom; and

††††† (e) Date x-ray taken and results as related to TB status.

††††† (8)(a)1. A local board of education shall require all school personnel exhibiting symptoms of chronic respiratory disease to undergo a TB risk assessment and examinations as indicated.

††††† 2. The evaluation and any recommended treatment for TB infection shall be based upon the directives of the local board of health and the Kentucky Department for Public Health.

††††† (b) An employee exposed to infectious TB shall be tested and, if necessary, treated for TB infection according to the directives of the local board of health.

††††† (c) In a county with an incidence of cases of active TB that is equal to or greater than the national average as established by the Department for Public Health, Division of Epidemiology, Tuberculosis Control Program, the local board of health may, with the approval of the Kentucky Department for Public Health, require more extensive testing of school district employees for TB.


††††† Section 2. Preventative Health Care Examinations. (1)(a) A local board of education shall require a preventative health care examination.

††††† (b) A second examination shall be required within one (1) year prior to entry into the sixth grade.

††††† (c) A third examination may be required by policy of the local board of education within one (1) year prior to entry into the ninth grade.

††††† (2) An out-of-state transfer student shall be required to submit documentation of a preventative health care examination.

††††† (3) A local school board may extend the deadline by which to obtain a preventative health care examination, not to exceed two (2) months.

††††† (4) A preventative health care examination shall be performed and signed for by a physician, an advanced practice registered nurse, a physician's assistant, or by a health care provider in the early periodic screening diagnosis and treatment programs.

††††† (5) A preventative health care examination shall be reported on the Preventative Health Care Examination Form, KDESHS002, and shall include:

††††† (a) A medical history;

††††† (b) An assessment of growth and development and general appearance;

††††† (c) A physical assessment including hearing and vision screening; and

††††† (d) Recommendations to the school regarding health problems that may require special attention in classroom or physical education activities.

††††† (6)(a) A vision examination shall be reported on the form, Kentucky Eye Examination Form for School Entry, KDESHS004.

††††† (b) A dental screening or examination shall be reported on the form, Kentucky Dental Screening/Examination Form for School Entry, KDESHS005.

††††† (7) A record of immunization shall be submitted on an Immunization Certificate, EPID-230.

††††† (8) A local school district shall establish a plan for implementation and compliance required for the sixth grade preventative health care examination.

††††† (9) A current Immunization Certificate, EPID-230, shall be on file within two (2) weeks of the child's enrollment in school.

††††† (10)(a) A board of education shall adopt a program of continuous health supervision for all school enrollees.

††††† (b) Supervision shall include scheduled, appropriate screening tests for vision and hearing.

††††† (11) A school shall have emergency care procedures, which shall include:

††††† (a) First aid facilities, including provisions for designated areas for the child to recline;

††††† (b) A requirement that whenever children are present during school hours, there shall be at least one (1) adult present in the school who is certified in a standard first aid course which includes CPR for infants and children;

††††† (c) A number at which parents can be reached; and

††††† (d) The name of a family physician.

††††† (12) A local board of education shall require immunizations as required by KRS 214.034.


††††† Section 3. Cumulative Health Records. (1) A school shall initiate a cumulative health record for each pupil entering its school.

††††† (a) The record shall be maintained throughout the pupil's attendance.

††††† (b) The record shall be uniform and shall be on the form Pupil's Cumulative Health Record, KDESHS006, or the record shall be maintained electronically in the student information system.

††††† (c) The record shall include screening tests related to growth and development, vision, hearing, and dental, and findings and recommendations of a physician and a dentist.

††††† (d) A follow-up by the proper health or school authorities shall be made on each abnormality noted, and the result shall be recorded.

††††† (2) A local school authority shall report all known or suspected cases of communicable disease immediately to the local health department.


††††† Section 4. Physical Environment. (1) A board of education shall provide and maintain a physical environment that is conducive to the health and safety of school children in each school under its jurisdiction.

††††† (2) A local board of education shall comply with current laws and administrative regulations applicable to all public buildings pertinent to health, sanitation, and safety.

††††† (3) A local board of education shall establish and maintain:

††††† (a) An adequate supply of water of safe, potable, sanitary quality;

††††† (b) A state-approved sanitary disposal of sewage, other water carried waste, and solid waste;

††††† (c) Adequate toilet and lavatory facilities, including soap or detergent as well as towels or other methods for drying hands, and other sanitary fixtures;

††††† (d) Adequate heating, lighting, and ventilation in all school buildings;

††††† (e) Adequate facilities and equipment for cafeterias and lunchrooms;

††††† (f) Supervision of general sanitation and safety of the school buildings, grounds, and playground equipment;

††††† (g) Beginning with the 2010-2011 school year, proof that all unlicensed school personnel who have accepted delegation to perform medication administration in school have completed a training course provided by the Kentucky Department of Education. This course shall be developed in consultation with the Kentucky Board of Nursing to ensure compliance with 201 KAR 20:400;

††††† (h) Adequate control of air pollutants; and

††††† (i) Universal precautions guidelines compatible with Occupational Safety and Health Administration requirements established in 803 KAR 2:320 and 29 C.F.R. 1910.1030.


††††† Section 5. A superintendent shall designate a person to serve as school health coordinator for the district. (1) The person designated shall meet the minimum qualifications required of this position as determined by the Educational Professional Standards Board in 16 KAR 4:010 or by the Kentucky Department of Education in the Local District Classification Plan for Class Code: 7271, as indicated in the document Setting Up Employee Classification Codes.

††††† (2) Class Title: School Health Coordinator for the district. The school health coordinator shall work in cooperation with all school personnel, the local board of education, the State Department of Education, the local health department, family resource and youth services centers, and parents in planning, promoting, and implementing a school health services program.


††††† Section 6. Incorporation by Reference. (1) The following material is incorporated by reference:

††††† (a) "Medical Examination of School Employees", KDESHS001, February 2012;

††††† (b) "Preventative Health Care Examination Form", KDESHS002, February 2012;

††††† (c) "Pupilís Cumulative Health Record", KDESHS006, March 2012;

††††† (d) "Setting Up Employee Classification Codes", March 2012;

††††† (e) "Kentucky Eye Examination Form for School Entry", KDESHS004, March 2012;

††††† (f) "Immunization Certificate", EPID-230, August 2010;


††††† (g) "Kentucky Dental Screening/Examination For School Entry", KDESHS005, March 2012.

††††† (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Division of District Support, Department of Education, 500 Mero Street, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m. (SBE 48.011; 1 Ky.R. 81; eff. 11-13-1974; Am. 5 Ky.R. 1086; eff. 8-1-1979; 7 Ky.R. 28; eff. 9-3-1980; 8 Ky.R. 1162; 9 Ky.R. 114; eff. 6-22-1982; 1315; eff. 7-6-1983; 17 Ky.R. 2245; eff. 3-13-1991; 18 Ky.R. 1202; 2256; eff. 1-10-1992; 19 Ky.R. 2494; 20 Ky.R. 75; 509; eff. 8-5-1993; 26 Ky.R. 1449; eff. 3-10-2000; 27 Ky.R. 1332; eff. 1-15-2001; 34 Ky.R. 628; 1421; eff. 1-4-2008; 36 Ky.R. 653; 1218; eff. 1-4-2010; Recodified from 704 KAR 4:020, 1-13-2012; 38 Ky.R. 1799; 39 Ky.R. 28; eff. 7-13-2012.)