Medical Professionals Assisting
the School Health Program
49 PA Code, Chapter 18 Practitioners Other than Medical Doctors, Subchapter H
Regulations pertaining to scope of practice for athletic trainers.
Athletic trainers, according to their scope of practice, must have a "written referral or prescription from a licensed physician, dentist or podiatrist or is subject to a written protocol for treatment...from a licensed physician." Nurses may NOT delegate medication administration to athletic trainers.
Certified Registered Nurse Practitioner (CRNP)
49 PA Code, Chapter 21 State Board of Nursing, Subchapter C
Regulations pertaining to scope of practice for CRNPs.
School nurses may carry additional licensure as a CRNP. Job descriptions should be edited to reflect CRNP practice. CRNPs are required to follow licensure requirements, regardless of the setting in which they practice. The CRNP may NOT serve as the school physician. However, they may perform mandated school examinations.
49 PA Code, Chapter 5 State Board of Chiropractic
A chiropractor's scope of practice is limited to the neuro-muscular system. They may write excuses for PE and school if the student's condition falls within their scope of practice. It is NOT in their scope of practice to: complete student or staff physicals; write prescriptions for medications; sign medical exemptions for immunizations or write dietary restrictions.
Emergency Medical Services (EMS) Providers
28 PA Code, Part VII Emergency Medical Services, Subpart A EMS System, Chapter 2013 Personnel, Subchapter B
Scope of Practice for Emergency Medical Service Providers; Update to 2014 Notice
PA Bulletin, January 17, 2015. This notice applies to emergency medical responders (EMR), emergency medical technicians (EMT), advanced emergency medical technicians (AEMT), paramedics (P), prehospital registered nurses (PHRN), prehospital physician extenders (PHPE) and prehospital physicians (PHP). EMRs, EMTs, AEMTs and Ps may only perform the skills identified, through either Statewide or other Department-approved protocols, or skills that may be ordered online by a medical command physician. The scope of practice for an EMS Provider does NOT allow for routine administration of medications.
Licensed Practical Nurse (LPN)
49 PA Code, Chapter 21 State Board of Nursing, Subchapter B
The LPN regulations require that they function as a member of the healthcare team. In the school setting, they serve as Supplemental Staff under the Certified School Nurse (CSN).
Physician Assistant (PA)
49 PA Code, Chapter 18 Practitioners Other than Medical Doctors, Subchapter D
The PA may NOT serve as the school physician. However, they may complete mandated school examinations of student and staff.
Registered Nurse (RN), non-certified
49 PA Code, Chapter 21 State Board of Nursing, Subchapter A
An RN working in the school setting, who is not certified as an Educational Specialist- School Nurse through the Department of Education is considered Supplemental Staff working as part of the healthcare team under the CSN.