Provision of School
Health Services to Private/Non-public Schools
In 1962, the legislature passed the School Nurse Act. This
act was considered revolutionary at the time because it required equitable
services be provided to students, whether they attended public or non-public
schools. This law remains in effect today as Section 1402(a.1) of the
Pennsylvania Public School Code.
The Department of Health regulations state in Section 23.51
“A child in private, parochial and public schools shall be provided with school
nurse services in the school which the child attends;” and Section 23.52 “The
school nurse services shall be provided through the public school system and
the administration of this service shall be the responsibility of the public
school administrator in consultation, as needed, with the private or parochial
School nurse services are considered to be one of the
mandated services (same as examinations and screens) and include the same
nursing functions as those provided to students in public school buildings,
such as assessment of student health care needs, development of appropriate
plans of care, medication administration, first aid and emergency care, etc.
Neither the law nor regulation distinguish differences in the level of service
to public vs. non-public schools.
Many school districts include private and non-public schools
as buildings being served in the School Health Annual Reimbursement Request
System (SHARRS). The school district receives the same level of reimbursement
for these students as those attending the public school buildings. Therefore,
the expectation is that all students receive equitable nursing services from
the school district. Provision of non-equitable services could adversely affect
the school district’s reimbursement.
Many of the nursing services can be performed by
supplemental licensed health staff such as non-certified RNs and LPNs working
in consultation with the CSN.
In addition, the Pennsylvania Public School Code (PSC)
requires that schools educate students and provide a safe, healthy environment.
The PSC (Section 1401 ) also requires that schools employ nurses. Section
1402(a.1) requires that “every child of school age shall be provided with
school nurse services…” In the School Health regulations, 28 PA Code, Chapter
23, Section 23.74, it is a function of the school nurse to interpret the health
needs of individual children.
However, school nurses don’t just function under Educational
law. They are licensed by the Department of State, Board of Nursing and
licensure requirements are in effect regardless of the nurse’s practice
setting. The Nurse Practice regulations require (49 PA Code, Chapter 21,
Section 21.11) that nurses follow the “standards of practice and professional
codes of behavior” published by the American Nurses Association as the
“criteria for assuring safe and effective practice.” The standards are
“authoritative statements of the duties that all registered nurses, regardless
of role, population, or specialty, are expected to perform competently.” These
standards outline the nursing process for provision of safe care (assessment,
nursing diagnosis, outcomes identification, planning, implementation,
coordination of care and evaluation).
nurses cannot effectively follow these standards of practice unless they rotate
through all of the buildings in their caseload assignment on a “regular basis”.
This could mean daily or it could mean 1-2 days/month. It depends on the
assessment of student needs as determined by the school nurse.
Updated: Jan. 9, 2017