As students returned to school in fall 2021, school nurses played a critical role in ensuring the ongoing health and safety of students. Though school nurses have historically led efforts to mitigate the spread of communicable diseases, their role has shifted significantly over time, and new COVID-19 responsibilities only added to school nurses’ already full plates. Even before the pandemic, school nurses were responsible for a wide range of tasks, including managing chronic disease, creating and coordinating individual student health plans, administering and storing medications, training school staff in emergency procedures and medication administration, and keeping and reporting records and health information. School nurses typically performed these services for multiple school buildings (as of 2017, only 39.3 percent of schools had a full time school nurse). Now, school nurses have become responsible for administering COVID-19 tests; helping with vaccination clinics; facilitating immunizations and health screenings that had been disrupted during remote learning; conducting contact tracing; enforcing general COVID protocols; and providing COVID-19 education to students, staff, and families—all in addition to their regular duties.
State statutes and regulations dictate not only whether schools are required to employ a school nurse, but also what qualifications they must have and what they must do once they arrive in school buildings. Moreover, state policies highlight whether and how the role of a school nurse is valued, particularly as an expert in the wake of public health crises like COVID-19. Understanding the current landscape of state statutes and regulations that govern school nursing is critical to identifying opportunities to better support and elevate school nurses’ role as longstanding pillars of public health.
Child Trends, in partnership with EMT Associates, analyzed the landscape of state statutes and regulations as of October 2021 to better understand how such policies define the role of school nurses (see Methodology). This brief presents our findings.
Findings
State policies on whether districts must employ school nurses
Thirty-five states and the District of Columbia (DC) have policies requiring (“must,” “shall”) the employment of school nurses, while another seven states authorize (“may”), encourage (“should”), or address making school nurses available to students (Appendix A). However, even among states that require making school nurses available, those requirements range from full-time nurses in each school to part-time nurses providing services to several schools to nurses employed at the LEA level. For example, two states (Delaware and Vermont) require full-time nurses in every school, and an additional twelve states (Alabama, Arkansas, Georgia, Indiana, Iowa, Oregon, Pennsylvania, Tennessee, Utah, Vermont, Virginia, and West Virginia) set recommended or required nurse-to-student ratios, though these ratios go unheeded by many districts. Notably, those ratios range from 1:500 (Alabama, Vermont) to 1:3,000 (Tennessee), while the Centers for Disease Control and Prevention recommends a ratio of one school nurse for every 750 students. Eight states (Alaska, Arizona, Idaho, Maryland, Montana, Nevada, New Mexico, and North Dakota) do not address requirements for school districts to employ school nurses.
State policies on whether districts must employ school nurses
State policies on school nurses’ qualifications
Thirty-one states and DC have policies that require specific educational qualifications or licenses/certifications for school nurses, while another nine states discuss licensing, certification, and educational qualifications by encouraging (discussing the benefits of) or addressing (by defining) such qualifications (Appendix B). Most states require school nurses to be licensed as a registered nurse (RN) by the state board of nursing with a bachelor’s or master’s degree from an accredited institution. Other permitted licenses and certifications for school nurses include licensed practical nurses (LPNs) (Alabama, Mississippi, New Hampshire, South Carolina), licensed public health nurses (Washington, Wisconsin), certified nursing assistants (CNAs) (New Hampshire), and certified nurse practitioners (CNPs) (Tennessee). Fourteen states’ departments of education (California, Connecticut, Delaware, Illinois, Indiana, Michigan, Nevada, New Hampshire, New Jersey, New Mexico, Ohio, Oregon, Vermont, West Virginia) require additional educational course work to receive and then maintain a state certification as a school nurse, in addition to the RN state license. Other common qualifications for school nurses include certification in first aid, cardiopulmonary resuscitation (CPR), and automatic external defibrillator (AED) use.
Some states’ policies authorize non-certified staff to provide supplemental services, such as medication administration, emergency care, or health screenings, if they are trained and supervised by a registered school nurse.
State policies on school nurses’ qualifications
State policies on school nurses’ role in managing chronic conditions
Forty-eight states have policies that describe school nurses’ role in managing chronic conditions, including allergies, diabetes, and seizures (Appendix C). Responsibilities include storing and administering medication; developing and implementing student health plans related to these conditions; and training other school personnel on chronic disease care (e.g., recognizing symptoms, emergency administration of medication). Of these, 39 states require (“must,” “shall”) a registered (or otherwise properly licensed or certified) nurse to perform these services, while eight states authorize (“may”) but do not require school nurses to fill these roles, giving some flexibility to who performs these duties. Oregon addresses the non-liability of school nurses, school administrators, teachers, or other school staff related to administering medication or supervising student self-administration of medication. Notably, there is a nationwide school nurse shortage, which may mean that schools are asking staff without proper medical training to perform these duties, even when the state requires proper licensure or certification. Schools may put students at risk when non-nurses perform duties that should be performed by qualified individuals.
State policies on school nurses’ role in managing chronic conditions
State policies on school nurses’ role in administering medication
Twenty-five states have policies that describe school nurses’ role in administering medication beyond what is specifically required for managing chronic conditions (Appendix D). These responsibilities include storing and administering students’ prescription medicine, managing students’ health records and parental consents, training other school personnel to administer prescription medication as permitted by parents or guardians, and assessing students’ ability to self-administer medication. Of states with policies addressing medication administration, 18 specifically require (“must,” “shall”) school nurses to perform these duties, while five states authorize (“may”) but do not require school nurses to fill these roles, which allows unlicensed assistive personnel, school administrators, teachers, or other school staff to perform these duties.
State policies on school nurses’ role in administering medication
State policies on school nurses’ role in developing and managing student health plans
Twenty-one states have policies that describe school nurses’ role in developing and managing student health plans for chronic conditions such as allergies, asthma, diabetes, and seizures as well as other individualized health care needs (Appendix E). Responsibilities addressed include training other school personnel and volunteer health aides on proper procedures of care; collaborating with students, parents or guardians, and primary care physicians; developing protocol for emergency response; and storing emergency stock medication. Of the states that govern school nurses’ role in student health plans, 17 require (“must,” “shall”) a registered nurse to be involved in creating individualized student health and emergency action plans, while two states authorize (“may”) but do not require school nurses to assist students who require individualized health care services. Importantly, the assessment and care planning can be done only by an RN—assessment is not in the scope of practice for LPNs. In cases where an RN is not present, student care plans may not exist or are provided from outside healthcare providers, often without proper adaption to the school setting or school-specific needs.
State policies on school nurses’ role in developing and managing student health plans
State policies on school nurses’ role in student health screenings
Twenty-five states have policies that describe school nurses’ roles in health screenings—including vision, hearing, dental, BMI, scoliosis, dyslexia, lead exposure, and general physical health (Appendix F). Their responsibilities range from scheduling, facilitating, documenting results, and/or referring students for follow-up care. Nineteen states require (“must,” “shall”) school nurses to conduct or oversee these screenings, receive training on specific screenings or examinations, or train other personnel to conduct the screenings, while six states authorize (“may”) or encourage (“recommend,” “should”) but do not require school nurses to fill these roles.
State policies on school nurses’ role in student health screenings
State policies on school nurses’ role in student immunizations
Twelve states have policies that describe school nurses’ role in facilitating and/or keeping records of student immunizations (Appendix G). Of these, ten states detail requirements for school nurses to administer immunizations, facilitate immunization programs or clinics, or keep or access records of student immunizations. New Mexico authorizes school nurses to access the immunization registry, while Texas authorizes school nurses to submit a written statement of a student’s immunity or disease history in lieu of a vaccine record for varicella.
State policies on school nurses’ role in student immunizations
State policies on school nurses’ role in infectious disease control
Eighteen states and DC have policies that describe school nurses’ role in mitigating the spread of contagious diseases (Appendix H). Of these, five states (Maine, New York, Oregon, Pennsylvania, West Virginia) and DC require schools to exclude students from school who have been exposed to a communicable disease or who are showing signs of illness as reported to them by school nurses, while four states (Massachusetts, New Jersey, Oklahoma, Wisconsin) authorize but do not require schools to do so. Oregon and Pennsylvania’s policies require nurses to determine when excluded students are no longer communicable and may be readmitted, while Idaho, Oklahoma, and New York authorize but do not require school nurses to perform this duty. Three states (Georgia, Maine, Pennsylvania) and DC require school personnel to consult with the school nurse when a student is suspected of having a communicable disease, while nine states (Idaho, Iowa, Maryland, Massachusetts, Nebraska, New Mexico, Oregon, West Virginia, Wisconsin) and DC require school nurses to report suspected cases of communicable diseases to state and local public health agencies.
State policies on school nurses’ role in infectious disease control
State policies on school nurses’ role in COVID-19
As of October 2021, policies in three states explicitly addressed school nurses’ role in COVID-19. New Mexico requires school nurses to use the Centers for Disease Control and Prevention (CDC) recommended transmission-based precautions when caring for sick people. New York allowed health examinations, including hearing, vision, and scoliosis screenings to be waived during the 2020-2021 school year due to COVID-19. Maine also updated an existing regulation on comprehensive health and safety and emergency management plans to require involving school nurses, physicians, and public health staff in developing and annually updating those plans. Four additional states (Delaware, Maryland, Vermont, and West Virginia) updated policies referencing either immunization or communicable disease between March 2020 and October 2021; however, these policies do not specifically mention COVID-19. Delaware also passed emergency legislation on COVID-19 Mitigation and Prevention requiring mask use by all students, faculty, staff, and visitors inside school buildings; however, the policy does not delegate a person responsible for ensuring that the policy is implemented or enforced.
State policies on school nurses’ role in COVID-19
Discussion and Conclusion
Our analysis examined how states govern the roles, responsibilities, and requirements for school nurses through policy. These policies often determine the availability of nurses in school buildings, the daily responsibilities they perform in service to their students, and expectations for how they will contribute to public health. The COVID-19 pandemic added significantly to existing responsibilities as school nurses stepped in to administer COVID-19 tests; conduct contact tracing; educate staff, students, and families on COVID-19 precautions, such as proper mask wearing, hand washing and hygiene, and physical distancing; update school-based health protocols and safety plans; and support decision making for school closing/reopening plans. The pandemic has increased the need for school nurses—who address and support efforts related to chronic absenteeism and the impact of health conditions on academic outcomes—and added to school nurses’ direct care responsibilities as students return to school demonstrating worsened physical and mental health.
Our analysis was necessarily limited: although we examined the landscape of state policies, we did not evaluate their effect in practice. The presence or absence of state-level policy pertaining to school nurses does not preclude the existence of non-codified guidance, nor does it indicate whether or how well policies are being implemented. However, from what is codified, we can assess the baseline expectations of school nurses. School nurses are required to fulfill numerous codified responsibilities around coordinating care or providing direct health services in all 50 states and DC and have been asked to take on even more during the COVID-19 pandemic. Despite these copious and ever-increasing demands, few states have policies that set a strong floor for school nurse capacity in schools—just twelve states have policies addressing recommended or required nurse-to-student ratios and only two require a full-time nurse in every school. By establishing policies that improve school nurses’ capacity, states can vest power in nurses’ deep expertise to lead their school communities’ health and wellness efforts on behalf of students and staff.
Methodology
To analyze the current landscape of state statutes and regulations related to school nursing practice, Child Trends and EMT Associates identified codified policies using a series of keyword Boolean searches in LexisNexis and Westlaw that reference school nursing. Policies repealed before October 2021 were not included in the search, nor were policies passed after this date or pending legislative action. Based on the content of each identified policy, researchers at EMT Associates conducted memoing to describe unique categories of policies. They then coded each identified policy based on its degree of prescriptiveness (addressed, encouraged, authorized, or required). Our analysis focused on the following research questions:
- How do states govern the availability of school nurses?
- How do states govern certifications or qualifications for school nurses?
- What are school nurses authorized to do?
- What are school nurses required to do?
- How are school nurses engaged in public health efforts?
- What specific responsibilities do school nurses have with respect to the COVID-19 pandemic?
Suggested Citation
Steed, H., O’Toole, D., Lao, K., Nuñez, B., Surani, K., & Stuart-Cassel, V. (2022). State laws on school nursing outline copious responsibilities for nurses. Child Trends. https://doi.org/10.56417/2161j1674h
This publication is supported by cooperative agreement NU87PS004367-01-01 funded by the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views or endorsement of the CDC or the Department of Health and Human Services.
Appendices
State
Code
Citation(s)
Alabama
Required
Ala. Code § 16-22-16
Alaska
Not Addressed
Arizona
Not Addressed
Arkansas
Required
Ark. Code Ann. § 6-18-706 ; Ark. Code Ann. § 6-20-2517
California
Required
Cal. Educ. Code § 49426
Colorado
Authorized
Colo. Rev. Stat. Ann. § 25-1.5-406
Connecticut
Required
Conn. Gen. Stat. Ann. § 10-212
Delaware
Required
Del. Code Ann. tit. 14, § 1310
District of Columbia
Required
D.C. Code Ann. § 38-621
Florida
Addressed
Fla. Stat. § 381.0057
Georgia
Required
Ga. Code Ann. § 20-2-771.2; Ga. Code Ann. § 20-2-186
Hawaii
Addressed
HAR 11-146-2
Idaho
Not Addressed
Illinois
Required
105 ILCS 5/10-22.23; Ill. Admin. Code tit. 23, § 1.760
Indiana
Required; Authorized; Encouraged; Addressed
511 Ind. Admin. Code 4-1.5-2; 511 Ind. Admin. Code 4-1.5-6; Burns Ind. Code Ann. § 16-22-8-34; Burns Ind. Code Ann. § 16-46-3-2; Burns Ind. Code Ann. § 20-34-3-6; Burns Ind. Code Ann. § 20-34-3-7; Burns Ind. Code Ann. § 20-34-4.5-4
Iowa
Required; Authorized
281 IAC 12.4; Iowa Code § 249A.32B; Iowa Code § 256.11
Kansas
Required
Kan. Admin. Regs. 60-15-101
Kentucky
Required
KRS § 156.501
Louisiana
Required
LAC 28:CXV.503; La. Stat. Ann. § 17:28
Maine
Required
Me. Rev. Stat. tit. 20-A, § 6403-A; CMR 05-071-125
Maryland
Not Addressed
Massachusetts
Required; Authorized
Mass. Gen. Laws Ann. ch. 71, § 53; Mass. Gen. Laws Ann. ch. 71, § 53A ; 105 CMR 201.015; 603 CMR 18.05; 603 CMR 50.06
Michigan
Required; Authorized
Mich. Admin. Code R 340.1163; Mich. Comp. Laws Ann. § 380.1252
Minnesota
Required
Minn. R. 8710.6100; Minn. Stat. § 121A.21; Minn. Stat. § 125A.29
Mississippi
Required
Miss. Code Ann. § 37-14-1; Miss. Code Ann. § 37-14-3; Miss. Code Ann. § 41-79-5; Miss. Code Ann. § 41-79-53
Missouri
Authorized
Mo. Ann. Stat. § 168.171
Montana
Not Addressed
Nebraska
Required
Nebraska Admin. Code Title 471, Ch. 25
Nevada
Not Addressed
New Hampshire
Required; Encouraged; Addressed
RSA 21-N:6-a; RSA 186:13; RSA 189:49; RSA 200:27; RSA 200:29; RSA 200:31
New Jersey
Required; Encouraged; Addressed
N.J. Stat. § 18A:40-1; N.J. Stat. § 18A:40-3.1; N.J. Stat. § 18A:40-3.2; N.J. Stat. § 18A:40-3.3; N.J. Stat. § 18A:40-3.4; N.J.A.C. 6A:16-2.3
New Mexico
Not Addressed
New York
Required; Encouraged
NY CLS Educ § 901; NY CLS Educ § 902; NY CLS Educ § 912; NY CLS Educ § 1950; NY CLS Educ § 2503; NY CLS Pub Health § 356; 8 NYCRR § 136.2
North Carolina
Required
16 N.C.A.C. 6D.0402
North Dakota
Not Addressed
Ohio
Encouraged
ORC Ann. 3313.68; ORC Ann. 3313.72
Oklahoma
Required
O.A.C. § 210:35-3-107; 70 Okl. St. § 3-129.11
Oregon
Required; Authorized
OAR 581-022-2220; ORS § 336.201; ORS § 678.038
Pennsylvania
Required; Encouraged; Addressed
24 P.S. § 14-1402; 24 P.S. § 14-1405; 24 P.S. § 14-1410; 28 Pa. Code § 23.51; 28 Pa. Code § 23.52; 28 Pa. Code § 23.53; 28 Pa. Code § 23.62
Rhode Island
Required
R.I. Gen. Laws § 16-21-7; R.I. Gen. Laws § 16-21-8; R.I. Gen. Laws § 23-17-4.1
South Carolina
Required; Addressed
S.C. Code Ann. § 43-5-1235; S.C. Code Ann. § 59-10-210
South Dakota
Required
S.D. Codified Laws § 13-33A-1
Tennessee
Required; Authorized; Encouraged; Addressed
Tenn. Comp. R. & Regs. R. 1200-11-05-.02; Tenn. Comp. R. & Regs. R. 1200-11-05-.05; Tenn. Code Ann. § 49-3-359; Tenn. Code Ann. § 68-1-1201; Tenn. Code Ann. § 68-1-1203
Texas
Required; Authorized
Tex. Educ. Code § 21.002; Tex. Health & Safety Code § 281.0465
Utah
Required; Encouraged
Utah Code Ann. § 53F-2-415; Utah Code Ann. § 53G-9-204
Vermont
Required
CVR 22-000-003
Virginia
Required; Encouraged
Va. Code Ann. § 22.1-253.13:2; Va. Code Ann. § 22.1-274
Washington
Authorized; Encouraged
Rev. Code Wash. (ARCW) § 28A.210.300; Rev. Code Wash. (ARCW) § 28A.210.305
West Virginia
Required
W. Va. Code § 18-5-22; W. Va. CSR § 126-25A-7; W. Va. CSR § 126-25A-9
Wisconsin
Required; Encouraged
Wis. Adm. Code PI 8.01; Wis. Stat. § 120.13
Wyoming
Encouraged
Wyo. Stat. § 21-2-202
State
Code
Citation(s)
Alabama
Required
Ala. Code § 16-22-16
Alaska
Not Addressed
Arizona
Not Addressed
Arkansas
Not Addressed
California
Required
Cal. Educ. Code § 44267.5; Cal. Educ. Code § 44877; Cal. Code Regs. tit. 5, § 80050
Colorado
Required
1 Colo. Code Regs. § 301-101:7.05
Connecticut
Required; Encouraged
Conn. Agencies Regs. 10-212-2; Conn. Agencies Regs. 10-212-4; Conn. Agencies Regs. 10-212-5; Conn. Agencies Regs. 10-212-6
Delaware
Required
Code Del. Regs. 1582
District of Columbia
Required
D.C. Code Ann. § 38-621
Florida
Required
Fla. Stat. § 1012.55
Georgia
Not Addressed
Hawaii
Addressed
HAR 11-146-2
Idaho
Required
Idaho Code § 33-1201
Illinois
Required
Ill. Admin. Code tit. 23, § 23.120
Indiana
Required
511 Ind. Admin. Code 15-6-35
Iowa
Required
281 IAC 12.4
Kansas
Required
K.S.A. § 72-255
Kentucky
Required
KRS § 156.501
Louisiana
Required
LAC 28:CXXXI.411
Maine
Required
CMR 05-071-125
Maryland
Required
COMAR 13A.05.05.13
Massachusetts
Required; Authorized
Mass. Gen. Laws Ann. ch. 71, § 53; Mass. Gen. Laws Ann. ch. 71, § 53A
Michigan
Required; Addressed
Mich. Admin. Code R 340.1161; Mich. Admin. Code R 340.1164; Mich. Admin. Code R 340.1166; Mich. Admin. Code R 340.1167; Mich. Admin. Code R 340.1168; Mich. Admin. Code R 340.1169
Minnesota
Required
Minn. Stat. § 121A.21
Mississippi
Addressed
CMSR 07-000-003
Missouri
Not Addressed
Montana
Not Addressed
Nebraska
Not Addressed
Nevada
Required
Nev. Admin. Code 391.305; Nev. Admin. Code 391.310
New Hampshire
Required; Encouraged
N.H. Admin. Rules, Ed 306.12; RSA 200:29
New Jersey
Required; Addressed
N.J. Stat. § 18A:40-3.3; N.J. Stat. § 18A:40-3.7; N.J. Stat. § 18A:40-3.8
New Mexico
Addressed
N.M. Admin. Code 6.63.2; N.M. Stat. Ann. § 22-34-2
New York
Required
8 NYCRR § 136.2
North Carolina
Required
16 N.C.A.C. 6D.0402
North Dakota
Not Addressed
Ohio
Addressed
OAC Ann. 3301-24-05
Oklahoma
Addressed
70 Okl. St. § 1-116
Oregon
Required; Encouraged; Addressed
ORS § 342.455; ORS § 342.465; ORS § 342.475; ORS § 342.485; ORS § 342.495; OAR 584-021-0110
Pennsylvania
Required
28 Pa. Code § 23.54
Rhode Island
Required
216 RICR 020-10-4
South Carolina
Required
S.C. Code Regs. 43-205
South Dakota
Required
S.D. Codified Laws § 13-33A-1
Tennessee
Required; Encouraged
Tenn. Comp. R. & Regs. R. 1200-11-05-.05; Tenn. Code Ann. § 49-3-359
Texas
Not Addressed
Utah
Encouraged
Utah Code Ann. § 53G-9-204
Vermont
Addressed
7-1 Vt. Code R. § 13
Virginia
Encouraged
Va. Code Ann. § 22.1-274
Washington
Encouraged
Rev. Code Wash. (ARCW) § 28A.210.300
West Virginia
Required
W. Va. Code § 18-5-22; W. Va. CSR § 126-25A-9
Wisconsin
Required; Encouraged
Wis. Adm. Code PI 8.01; Wis. Stat. § 120.13
Wyoming
Not Addressed
State
Code
Citation(s)
Alabama
Required; Authorized; Addressed
Ala. Code § 16-1-48; Ala. Code § 16-30A-3; Ala. Code § 16-30A-5; Ala. Code § 16-30C-2; Ala. Code § 16-30C-4; Ala. Admin. Code 610-X-7-.10
Alaska
Authorized
Alaska Stat. Ann. § 14.30.141
Arizona
Required; Authorized
Ariz. Admin. Code R7-2-809; Ariz. Admin. Code R7-2-810; Ariz. Rev. Stat. Ann. § 15-157; Ariz. Rev. Stat. Ann. § 15-158; Ariz. Rev. Stat. Ann. § 15-342; Ariz. Rev. Stat. Ann. § 15-344.01
Arkansas
Required
Code Ark. R. 005.28.42-4.00; Code Ark. R. 005.28.42-7.00; 067 00 CARR 009; Ark. Code Ann. § 6-18-707
California
Required; Authorized
Cal. Educ. Code § 49414; Cal. Educ. Code § 49414.5; Cal. Educ. Code § 49423.1
Colorado
Required
Colo. Rev. Stat. Ann. § 22-1-119.5; Colo. Rev. Stat. Ann. § 22-1-132; Colo. Rev. Stat. Ann. § 22-2-135; 1 Colo. Code Regs. § 301-68:2.00; 1 Colo. Code Regs. § 301-68:3.00; 1 Colo. Code Regs. § 301-68:4.00; 1 Colo. Code Regs. § 301-68:5.00
Connecticut
Required
Conn. Agencies Regs. 10-212a-2
Delaware
Required; Addressed
Code Del. Regs. 612; Del. Code Ann. tit. 16, § 3003E; Del. Code Ann. tit. 16, § 3007E
District of Columbia
Not Addressed
Florida
Required
Fla. Admin. Code Ann. r. 6A-6.0251; Fla. Admin. Code Ann. r. 6A-6.0253
Georgia
Required
Ga. Code Ann. § 20-2-776; Ga. Code Ann. § 20-2-779
Hawaii
Not Addressed
Idaho
Required; Addressed
Idaho Code § 33-520; Idaho Code § 33-520A
Illinois
Required
105 ILCS 5/2-3.182; 105 ILCS 145/15; 105 ILCS 145/27; Ill. Admin. Code tit. 23, § 1.540
Indiana
Required; Authorized
Burns Ind. Code Ann. § 20-34-3-26; Burns Ind. Code Ann. § 20-34-5-12; Burns Ind. Code Ann. § 20-34-5-13; Burns Ind. Code Ann. § 20-34-5-14; Burns Ind. Code Ann. § 20-34-5-15; Burns Ind. Code Ann. § 20-34-5-17
Iowa
Required; Authorized
281 IAC 14.3(256); Iowa Code § 280.16; Iowa Code § 280.16A
Kansas
Required
K.S.A. § 72-6282
Kentucky
Required
KRS § 158.834; KRS § 158.836
Louisiana
Required
LAC 28:CLVII.307; La. Stat. Ann. § 17:436.1; La. Stat. Ann. § 17:436.3
Maine
Required; Authorized
Me. Rev. Stat. tit. 20-A, § 254; 20-A M.R.S. § 6305
Maryland
Required
Md. Code Ann., Educ. § 7-426.2; Md. Code Ann., Educ. § 7-426.4
Massachusetts
Required; Addressed
Mass. Gen. Laws Ann. ch. 71, § 54B; 105 CMR 210.100
Michigan
Authorized
Mich. Comp. Laws Ann. § 333.17744a
Minnesota
Required
Minn. Stat. § 121A.24; Minn. Stat. § 121A.221
Mississippi
Required
Miss. Code Ann. § 37-11-71; Miss. Code Ann. § 41-79-1; Miss. Code Ann. § 41-79-3
Missouri
Required; Authorized
Mo. Code Regs. Ann. tit. 5, § 20-200.300; Mo. Ann. Stat. § 167.630; Mo. Ann. Stat. § 167.635; Mo. Ann. Stat. § 167.803; Mo. Ann. Stat. § 167.809
Montana
Required; Authorized
Mont. Code Ann. § 20-5-420; Mont. Code Ann. § 20-5-421
Nebraska
Required
Neb. Rev. Stat. Ann. § 79-224; Neb. Rev. Stat. Ann. § 79-3203
Nevada
Authorized
Nev. Rev. Stat. Ann. § 386.870; Nev. Rev. Stat. Ann. § 392.425
New Hampshire
Required; Encouraged; Authorized; Addressed
RSA 200:42; RSA 200:43; RSA 200:44; RSA 200:44-a; RSA 200:45; RSA 200:46; RSA 200:54; RSA 200:55; RSA 200:57
New Jersey
Required; Authorized; Addressed
N.J. Stat. § 18A:40-12.5; N.J. Stat. § 18A:40-12.6; N.J. Stat. § 18A:40-12.6c; N.J. Stat. § 18A:40-12.6d; N.J. Stat. § 18A:40-12.7; N.J. Stat. § 18A:40-12.8; N.J. Stat. § 18A:40-12.11; N.J. Stat. § 18A:40-12.13; N.J. Stat. § 18A:40-12.14; N.J. Stat. § 18A:40-12.35; N.J.A.C. 6A:16-2.1; N.J.A.C. 6A:16-2.2
New Mexico
Required; Authorized
6.12.2.9 NMAC; 6.12.8.8 NMAC; 6.12.11.10 NMAC; 7.30.12.10 NMAC; N.M. Stat. Ann. § 22-5-4.3; N.M. Stat. Ann. § 22-33-3; N.M. Stat. Ann. § 22-33-4; N.M. Stat. Ann. § 22-34-5
New York
Required; Authorized
NY CLS Educ § 902-a; NY CLS Educ § 902-b; NY CLS Educ § 916; NY CLS Educ § 916-a; NY CLS Educ § 916-b; NY CLS Educ § 921; NY CLS Pub Health § 2500-h; 8 NYCRR § 136.7
North Carolina
Required
N.C. Gen. Stat. § 115C-12; N.C. Gen. Stat. § 115C-375.2; N.C. Gen. Stat. § 115C-375.2A
North Dakota
Not Addressed
Ohio
Required; Authorized
ORC Ann. 3313.718; ORC Ann. 3313.719; ORC Ann. 3313.7110; ORC Ann. 3313.7112; ORC Ann. 3313.7113; ORC Ann. 3313.7115
Oklahoma
Required; Authorized
70 Okl. St. § 1-116.3; 70 Okl. St. § 1210.196.3; 70 Okl. St. § 1210.196.4; 70 Okl. St. § 1210.196.5
Oregon
Addressed
ORS § 339.871
Pennsylvania
Required; Authorized
24 P.S. § 14-1414.1; 24 P.S. § 14-1414.2; 24 Pa. Stat. Ann. § 14-1414.3
Rhode Island
Required; Authorized
R.I. Gen. Laws Ann. § 16-21-22; R.I. Gen. Laws § 16-21-32; 216 RICR 020-10-4
South Carolina
Authorized
S.C. Code Ann. § 59-63-95
South Dakota
Authorized
S.D. Codified Laws § 13-33A-6
Tennessee
Required
Tenn. Code Ann. § 49-50-1602; Tenn. Comp. R. & Regs. R. 0520-01-13-.03
Texas
Required; Authorized
Tex. Educ. Code § 38.015; Tex. Educ. Code § 38.208; Tex. Health & Safety Code § 168.003; Tex. Health & Safety Code § 168.005; Tex. Health & Safety Code § 168.007; 25 TAC § 40.44; 25 TAC § 40.46; 25 TAC § 40.47
Utah
Required; Authorized
Utah Code Ann. § 26-41-104; Utah Code Ann. § 26-41-105; Utah Code Ann. § 53G-9-504; Utah Code Ann. § 53G-9-505
Vermont
Authorized
16 V.S.A. § 1388
Virginia
Required; Authorized
8 VAC 20-131-260; Va. Code Ann. § 22.1-274.01:1; Va. Code Ann. § 22.1-274.2; Va. Code Ann. § 22.1-274.6; Va. Code Ann. § 54.1-3408
Washington
Required; Encouraged
Wash. Rev. Code Ann. § 28A.210.355; Rev. Code Wash. (ARCW) § 28A.210.370; Rev. Code Wash. (ARCW) § 28A.210.380; Rev. Code Wash. (ARCW) § 28A.210.383
West Virginia
Required; Authorized
W. Va. Code § 18-2K-2; W. Va. Code § 18-5-22b; W. Va. Code § 18-5-22c; W. Va. CSR § 126-25A-11; W. Va. CSR § 126-25A-12; W. Va. CSR § 126-27-9; W. Va. CSR § 126-27-10
Wisconsin
Authorized
Wis. Stat. § 118.2925
Wyoming
Authorized
Wyo. Stat. § 21-4-316
State
Code
Citation(s)
Alabama
Not Addressed
Alaska
Not Addressed
Arizona
Not Addressed
Arkansas
Required
Ark. Code Ann. § 6-18-718
California
Required; Authorized
Cal. Educ. Code § 49423; Cal. Code Regs. tit. 5, § 600; Cal. Code Regs. tit. 5, § 604
Colorado
Addressed
Colo. Rev. Stat. Ann. § 12-255-132
Connecticut
Required
Conn. Gen. Stat. Ann. § 10-212a ; Conn. Agencies Regs. 10-212a-3; Conn. Agencies Regs. 10-212a-4; Conn. Agencies Regs. 10-212a-5; Conn. Agencies Regs. 10-212a-7; Conn. Agencies Regs. 10-212a-8; Conn. Agencies Regs. 10-212a-9
Delaware
Required
Del. Code Ann. tit. 16, § 3004E; Del. Code Ann. tit. 16, § 3006E; Code Del. Regs. 817
District of Columbia
Not Addressed
Florida
Not Addressed
Georgia
Not Addressed
Hawaii
Not Addressed
Idaho
Not Addressed
Illinois
Required
105 ILCS 5/10-22.21b; 105 ILCS 5/22-30; 105 ILCS 5/34-18.61
Indiana
Authorized; Addressed
Burns Ind. Code Ann. § 20-34-4.5-2; Burns Ind. Code Ann. § 20-34-4.5-4
Iowa
Not Addressed
Kansas
Required
Kan. Admin. Regs. 60-15-104; K.S.A. § 72-6282
Kentucky
Not Addressed
Louisiana
Required
LAC 28:CLVII.305
Maine
Required
Code Me. R. tit. 05-071 Ch. 40, § 2; Code Me. R. tit. 05-071 Ch. 40, § 3
Maryland
Required
Md. Code Ann., Educ. § 7-421
Massachusetts
Required; Addressed
105 CMR 210.001; 105 CMR 210.003; 105 CMR 210.004; 105 CMR 210.005; 105 CMR 210.006; 105 CMR 210.007; 105 CMR 210.008; 105 CMR 210.009; 603 CMR 18.05
Michigan
Addressed
Mich. Comp. Laws Ann. § 380.1178
Minnesota
Not Addressed
Mississippi
Not Addressed
Missouri
Required
Mo. Ann. Stat. § 167.627
Montana
Not Addressed
Nebraska
Not Addressed
Nevada
Required
Nev. Admin. Code 632.226
New Hampshire
Required
N.H. Admin. Rules, Ed 311.02
New Jersey
Required
N.J. Stat. § 18A:40-12.30; N.J. Stat. § 18A:40-12.32
New Mexico
Not Addressed
New York
Authorized
NY CLS Educ § 919
North Carolina
Not Addressed
North Dakota
Authorized; Encouraged; Addressed
N.D. Cent. Code, § 15.1-19-23; N.D. Cent. Code, § 23-44-03; N.D. Cent. Code, § 43-12.1-04; N.D. Cent. Code, § 43-12.1-16; N.D. Cent. Code, § 43-12.1-16.1
Ohio
Not Addressed
Oklahoma
Authorized
70 Okl. St. § 1-116.2
Oregon
Required; Addressed
OAR 581-021-0037; ORS § 339.873
Pennsylvania
Not Addressed
Rhode Island
Not Addressed
South Carolina
Not Addressed
South Dakota
Required
S.D. Codified Laws § 13-33A-1
Tennessee
Not Addressed
Texas
Not Addressed
Utah
Required
Utah Code Ann. § 53G-9-502
Vermont
Not Addressed
Virginia
Not Addressed
Washington
Authorized
Rev. Code Wash. (ARCW) § 28A.210.305
West Virginia
Required; Addressed
W. Va. CSR § 126-25A-10; W. Va. CSR § 126-27-3; W. Va. CSR § 126-27-6; W. Va. CSR § 126-27-7; W. Va. CSR § 126-27-8
Wisconsin
Not Addressed
Wyoming
Not Addressed
State
Code
Citation(s)
Alabama
Addressed
Ala. Code § 16-30A-2
Alaska
Not Addressed
Arizona
Authorized
Ariz. Rev. Stat. Ann. § 15-344.01
Arkansas
Required
Ark. Code Ann. § 6-18-718
California
Not Addressed
Colorado
Required
1 Colo. Code Regs. § 301-68:2.00
Connecticut
Not Addressed
Delaware
Not Addressed
District of Columbia
Not Addressed
Florida
Required; Addressed
Fla. Admin. Code Ann. r. 6A-6.0251; Fla. Admin. Code Ann. r. 6A-6.0252
Georgia
Required
Ga. Comp. R. & Regs. 160-4-8-.18
Hawaii
Authorized
HAR 11-146-6
Idaho
Not Addressed
Illinois
Required
105 ILCS 145/15
Indiana
Required
Burns Ind. Code Ann. § 20-34-5-12; Burns Ind. Code Ann. § 20-34-5-13; Burns Ind. Code Ann. § 20-34-5-16; Burns Ind. Code Ann. § 20-34-5-17
Iowa
Not Addressed
Kansas
Not Addressed
Kentucky
Not Addressed
Louisiana
Required
LAC 28:CLVII.307; La. Stat. Ann. § 17:436.3
Maine
Not Addressed
Maryland
Not Addressed
Massachusetts
Not Addressed
Michigan
Not Addressed
Minnesota
Not Addressed
Mississippi
Not Addressed
Missouri
Not Addressed
Montana
Not Addressed
Nebraska
Required
Neb. Rev. Stat. Ann. § 79-3203
Nevada
Not Addressed
New Hampshire
Not Addressed
New Jersey
Addressed
N.J. Stat. Ann. § 18A:40-12.34
New Mexico
Required
6.12.2.9 NMAC
New York
Not Addressed
North Carolina
Required
N.C. Gen. Stat. § 115C-12; 16 N.C.A.C. 6D.0402
North Dakota
Not Addressed
Ohio
Not Addressed
Oklahoma
Required
70 Okl. St. § 1210.196.3
Oregon
Not Addressed
Pennsylvania
Not Addressed
Rhode Island
Required
R.I. Gen. Laws § 16-21-32; 216 RICR 020-10-4
South Carolina
Required
S.C. Code Ann. § 59-63-80
South Dakota
Not Addressed
Tennessee
Required
Tenn. Code Ann. § 49-50-1601; Tenn. Code Ann. § 49-50-1602; Tenn. Comp. R. & Regs. R. 0520-01-13-.03
Texas
Required
Tex. Health & Safety Code § 168.003; Tex. Health & Safety Code § 168.007
Utah
Not Addressed
Vermont
Not Addressed
Virginia
Not Addressed
Washington
Required
Wash. Rev. Code Ann. § 28A.210.355
West Virginia
Required
W. Va. Code § 18-2K-2; W. Va. CSR § 126-25A-6
Wisconsin
Not Addressed
Wyoming
Not Addressed
State
Code
Citation(s)
Alabama
Not Addressed
Alaska
Required
Alaska Stat. Ann. § 14.30.127
Arizona
Required
Ariz. Rev. Stat. Ann. § 36-899.10
Arkansas
Required; Authorized
Code Ark. R. 005.28.18-8.0; Code Ark. R. 005.28.43-12.00; Ark. Code Ann. § 6-18-701; Ark. Code Ann. § 6-18-1501
California
Required; Authorized
Cal. Educ. Code § 33319; Cal. Educ. Code § 49452.5; Cal. Educ. Code § 49455; Cal. Code Regs. tit. 5, § 591; Cal. Code Regs. tit. 5, § 596
Colorado
Not Addressed
Connecticut
Required
Conn. Agencies Regs. 10-214-2; Conn. Agencies Regs. 10-214-3; Conn. Agencies Regs. 10-214-4; Conn. Gen. Stat. Ann. § 10-206
Delaware
Required
Code Del. Regs. 815
District of Columbia
Not Addressed
Florida
Not Addressed
Georgia
Authorized
Ga. Comp. R. & Regs. r. 511-5-6-.04
Hawaii
Not Addressed
Idaho
Not Addressed
Illinois
Required
Ill. Admin. Code tit. 23, § 1.760
Indiana
Not Addressed
Iowa
Not Addressed
Kansas
Not Addressed
Kentucky
Not Addressed
Louisiana
Authorized
LAC 28:CLVII.301; LAC 48:V.2103; La. Stat. Ann. § 17:2112
Maine
Required; Authorized
CMR 10-144-281; Code Me. R. tit. 05-071 Ch. 45, § 2; Code Me. R. tit. 05-071 Ch. 45, § 4
Maryland
Not Addressed
Massachusetts
Required
105 CMR 200.400
Michigan
Not Addressed
Minnesota
Authorized
Minn. Stat. § 121A.17
Mississippi
Encouraged; Addressed
Miss. Code Ann. § 37-23-15; CMSR 07-000-007
Missouri
Not Addressed
Montana
Not Addressed
Nebraska
Not Addressed
Nevada
Required
Nev. Admin. Code 385B.336; Nev. Rev. Stat. Ann. § 392.420
New Hampshire
Not Addressed
New Jersey
Required
N.J.A.C. 6A:16-2.2; N.J. Stat. § 18A:40-4.3; N.J. Stat. § 18A:40A-23; N.J. Stat. § 18A:40-41.7
New Mexico
Required; Authorized
N.M. Code R. § 7.30.11.8; N.M. Stat. Ann. § 22-13-30
New York
Required
NY CLS Educ § 903; NY CLS Educ § 904; 8 NYCRR § 136.3
North Carolina
Not Addressed
North Dakota
Not Addressed
Ohio
Not Addressed
Oklahoma
Not Addressed
Oregon
Required; Authorized
ORS § 336.211; OAR 581-021-0031
Pennsylvania
Required
28 Pa. Code § 23.11; 28 Pa. Code § 23.71; 28 Pa. Code § 23.73; 28 Pa. Code § 23.78
Rhode Island
Required
R.I. Gen. Laws § 16-21-10; 216 RICR 020-10-4
South Carolina
Required
S.C. Code Ann. § 44-29-195
South Dakota
Not Addressed
Tennessee
Not Addressed
Texas
Not Addressed
Utah
Required; Authorized
Utah Code Ann. § 53G-9-403; Utah Code Ann. § 53G-9-404; U.A.C. R384-201-8; U.A.C. R384-201-9; U.A.C. R384-201-10
Vermont
Not Addressed
Virginia
Not Addressed
Washington
Authorized
WAC § 246-760-080; WAC § 246-760-100
West Virginia
Required
W. Va. CSR § 126-51-5
Wisconsin
Authorized
Wis. Stat. Ann. § 118.25
Wyoming
Not Addressed
State
Code
Citation(s)
Alabama
Not Addressed
Alaska
Not Addressed
Arizona
Required
Ariz. Rev. Stat. Ann. § 36-673; Ariz. Rev. Stat. Ann. § 36-674
Arkansas
Not Addressed
California*
Required
Cal. Educ. Code § 49426
Colorado
Not Addressed
Connecticut
Not Addressed
Delaware
Required
Code Del. Regs. 804
District of Columbia
Not Addressed
Florida
Required
Fla. Stat. § 1003.22
Georgia
Not Addressed
Hawaii
Not Addressed
Idaho
Not Addressed
Illinois
Not Addressed
Indiana
Not Addressed
Iowa
Not Addressed
Kansas
Not Addressed
Kentucky
Not Addressed
Louisiana
Not Addressed
Maine*
Required
Code Me. R. tit. 05-071 Ch. 126, § 7; Code Me. R. tit. 10-144 Ch. 261, § 7; Code Me. R. tit. 10-144-261
Maryland
Not Addressed
Massachusetts*
Required; Authorized
105 CMR 300.191; Mass. Gen. Laws Ann. ch. 76, § 15
Michigan
Not Addressed
Minnesota
Not Addressed
Mississippi
Not Addressed
Missouri
Required
Mo. Ann. Stat. § 167.181
Montana
Not Addressed
Nebraska
Not Addressed
Nevada
Required
Nev. Rev. Stat. Ann. § 391.292
New Hampshire
Required
RSA 200:38
New Jersey
Not Addressed
New Mexico
Authorized
N.M. Stat. Ann. § 24-5-9
New York
Not Addressed
North Carolina
Not Addressed
North Dakota
Not Addressed
Ohio
Not Addressed
Oklahoma
Not Addressed
Oregon
Not Addressed
Pennsylvania
Not Addressed
Rhode Island
Not Addressed
South Carolina
Not Addressed
South Dakota
Not Addressed
Tennessee
Not Addressed
Texas
Authorized
25 Tex. Admin. Code § 97.65
Utah
Not Addressed
Vermont
Required; Authorized
18 V.S.A. § 1124; 18 V.S.A. § 1129; 12-5 Vt. Code R. § 5; CVR 13-140-021
Virginia
Not Addressed
Washington
Not Addressed
West Virginia
Not Addressed
Wisconsin
Not Addressed
Wyoming
Not Addressed
State
Code
Citation(s)
Connecticut
Required
Conn. Agencies Regs. 19a-36-A8
Rcol-N
District of Columbia
Required
D.C. Mun. Regs. tit. 22-B, § 209
RC-N; REx-N; RR-N
Georgia
Required
Ga. Comp. R. & Regs. 160-1-3-.03
RC-N
Idaho
Required
Idaho Admin. Code r. 16.02.10.020; Idaho Admin. Code r. 16.02.10.090
RR-N; A-RA-N
Illinois
Required
Ill. Admin. Code tit. 23, § 1.760
Rcol-N
Iowa
Required
641 IAC 1.4; 641 IAC 1.6
RR-N
Maine*
Required
Me. Rev. Stat. tit. 20-A, § 6301; Me. Rev. Stat. tit. 20-A, § 6402-A; Code Me. R. tit. 05-071 Ch. 126, § 6; Code Me. R. tit. 10-144 Ch. 261, § 6
RC-N; REx-S; AEx-N
Maryland
Required
COMAR 10.06.01.04
RR-N
Massachusetts*
Required
Mass. Gen. Laws Ann. ch. 71, § 55A
AEx-N; RR-N
Nebraska
Required
173 Neb. Admin. Code Ch. 1, 1-007; 173 Neb. Admin. Code Ch. 3, 3-004
RR-N
New Mexico
Required
6.12.14.8 NMAC; 7.4.3.8 NMAC
RR-N
New York
Required
8 NYCRR § 136.3
REx-S
Oregon
Required; Addressed
OAR 581-022-2220; ORS § 433.260
R-RA-N; REd-N; RR-N; REx-S
Pennsylvania
Required
28 Pa. Code § 27.71; 28 Pa. Code § 27.72; 28 Pa. Code § 27.73
REx-S; R-RA-N; RC-N
West Virginia
Required; Addressed
W. VA. CSR § 126-42-7; W. Va. CSR § 126-51-3; W. Va. CSR § 126-51-9
REx-N; RR-N; REd-BoE
Wisconsin
Required
Wis. Stat. § 252.21
AEx-N; RR-N
State
Code
Citation(s)
Alabama
Not Addressed
Alaska
Not Addressed
Arizona
Not Addressed
Arkansas
Not Addressed
California
Not Addressed
Colorado
Not Addressed
Connecticut
Not Addressed
Delaware
Updated
Code Del. Regs. 804; Code Del. Regs. 815
District of Columbia
Not Addressed
Florida
Not Addressed
Georgia
Not Addressed
Hawaii
Not Addressed
Idaho
Not Addressed
Illinois
Not Addressed
Indiana
Not Addressed
Iowa
Not Addressed
Kansas
Not Addressed
Kentucky
Not Addressed
Louisiana
Not Addressed
Maine
Addressed
Me. Rev. Stat. tit. 20-A, § 1001
Maryland
Updated
COMAR 10.06.01.04
Massachusetts
Not Addressed
Michigan
Not Addressed
Minnesota
Not Addressed
Mississippi
Not Addressed
Missouri
Not Addressed
Montana
Not Addressed
Nebraska
Not Addressed
Nevada
Not Addressed
New Hampshire
Not Addressed
New Jersey
Not Addressed
New Mexico
Addressed
6.12.14.8 NMAC
New York
Addressed
8 NYCRR § 136.3
North Carolina
Not Addressed
North Dakota
Not Addressed
Ohio
Not Addressed
Oklahoma
Not Addressed
Oregon
Not Addressed
Pennsylvania
Not Addressed
Rhode Island
Not Addressed
South Carolina
Not Addressed
South Dakota
Not Addressed
Tennessee
Not Addressed
Texas
Not Addressed
Utah
Not Addressed
Vermont
Updated
18 V.S.A. § 1129
Virginia
Not Addressed
Washington
Not Addressed
West Virginia
Updated
W. VA. CSR § 126-42-7
Wisconsin
Not Addressed
Wyoming
Not Addressed