Minnesota Legislation

* The following website may be used to search for any MN laws relating to public schools: http://www.revisor.leg.state.mn.us/stats/120.html  Minnesota school nurses should become familiar with the following chapters:

121A.21    School health services
121A.22    Administration of drugs and medicine
121A.221  Possession and use of asthma inhalers by asthmatic students
144.29       Health records; children of school age
121A.15    Health standards; immunizations; school children.
121A.17    Early childhood developmental screening
125A.21    IEP Third Party Billing
8710.6100 School Nurse Licensure

The 2004 Minnesota Legislature passed House File No. 1763, which allows students to carry their prescribed Epi-Pen® with them to school.  The Epi-Pen® is a prescription non-syringe injector of epinephrine.  It is used as a first line of defense against anaphylaxis, and allows for an immediate response to a potentially fatal incident.

This bill applies to:

• All schools subject to the federal Americans with Disabilities Act
• All students under the age of 18
• All students who have a history of anaphylaxis
• All students who have a current prescription for the medication

The parent and prescribing doctor must annually inform the school in writing that the student possesses, or requires access to the Epi-Pen®.  The school must develop an individualized health plan, and all school staff is responsible for implementing that plan from the time the student enrolls for the 2004-2005 school year.

For more information on anaphylaxis
For more information on the language of this bill (Article 2: Sections 6 and 7)
You can view Anaphylaxis Legislation: Now What? (PowerPoint format) as presented by Jean Currie, R.N., M.S. at the SNOM Fall Conference (10/04). The presentation is also available in PDF format.

In the fall of 2003, the Minnesota Department of Health (MDH) modified the immunization requirements for children in child care, grades K-12, and students at post-secondary institutions.  These changes do not alter the medical exemption or the option for parents to decline any or all vaccines due to conscientious objections.

Effective October 2003

1. Schedule: Shortens the grace period school-age children have to complete their primary immunization series from 18 to 8 months to make it easier for school nurses to bring children into compliance in the school year.
2. Schedule: Allows vaccine doses administered four or fewer days before the minimum age required in law to be considered valid in order to be consistent with nationally established recommendations.
3. Immunization Documentation: Requires all child care facilities and elementary and secondary schools to use the Minnesota Department of Health's official record form or a similar document approved by the department, when communicating to parents or guardians regarding immunization requirements and exemption procedures.  The record form requests information about immunizations and includes space for documenting medical or conscientious exemptions.
4. Hib Vaccine: Clarifies the current Haemophilus influenzae type b (Hib) dosage series by requiring that one dose be given at or after 12 months of age to be consistent with clinical guidelines.
5. Hepatitis B Vaccine: Allows both the three-dose and the alternate two-dose hepatitis B vaccine series for 11-15 year olds.
6. Suspension of Law: Gives the commissioner of health authority to suspend immunization law requirements (121A.15 and 135A.14) to address a vaccine shortage or emergency situation.

Effective September 2004

1. Varicella (Chickenpox): Requires documentation of varicella vaccine or history of disease for children age 18 months to 5 years who are enrolled in child care, as well as for school-age children in kindergarten and seventh grade.
   1. Signature of a provider and the date of the child's varicella illness; or
   2. Signature of a provider and a statement that a parent's or legal guardian's description of the disease history is indicative of past varicella infection; or
   3. Signature of a provider or a representative of a public clinic and laboratory evidence of the child's varicella immunity; or
   4. Signature of the child's parent or legal guardian and the year the child had varicella disease.  This item expires on September 1, 2010.
2. Pneumococcal: Requires documentation of pneumococcal conjugate vaccine for children enrolled in child care who are between 2 and 24 months of age.  This vaccine protects against meningitis, bloodstream infections, and pneumonia.
3. Measles, Mumps, Rubella Vaccine: Requires children entering kindergarten to provide documentation of a second dose of vaccine each for measles, mumps, and rubella.  (Minnesota currently requires and will continue to require the second dose for children in grades 7-12 until spring 2012.)

For more information and a detailed copy of the rule requirements, visit the Minnesota Department of Health Immunization Webpage.

The Medication Administration Task Force presented their recommendations to the legislature during this last session.  As a result of this study, MN Dept.of Health has reassigned a staff person (Cheryl Smoot) to full time School Health Consultant to begin the process of implementing these recommendations.  The School Medication Administrative Study can be accessed on the web site: http://www.health.state.mn.us/divs/fh/mch/schoolhealth/med-admin.html.

Third Party Billing - MS 125A.21 was amended and signed by the governor March, 2002. Changes include the following key points:

• School Districts will no longer need to obtain annual written consent from parents/guardians to bill for IEP health related services for children enrolled exclusively in the Medical Assistance and MinnesotaCare programs.  Instead, districts will be required to send an annual notification to the parents/guardians of these children, stating their intent to bill MA for these services.  Annual written parent/guardian consent forms will still be required for those students who have private insurance in whole or in part.) CFL and DHS will be working out the details for how districts notify parents.
• Language more specific to nursing services has been added.  It includes covering health assessments for the IEP process, and nursing services that would otherwise be covered by in a medical assistance program.
• NEW  (October 02) An Amendment to the 3rd Party Billing program was recently approved to allow billing for simple medication administration on students who have this included on their IEP as part of a health related service.  Districts may "back bill" for these services to April 1, 2002 if all the needed documentation is in place.

To become a member of the SNOM Legislative Committee, contact Liz Zeno or Denise Herrmann

Federal Legislation

• Amy Klobuchar   (Democrat) - Link to website and Email address
• Norm Coleman (Republican) - Link to website and Email address

• Write Your Rep Page - Find out who your representative is and link to their website and Email.

Search for Federal Legislative Information on the Internet

NEW  The Individuals with Disabilities Education Act (IDEA)
On November 19, 2004, Congress passed the compromise bill H.R. 1350 to reauthorize the Individuals with Disabilities Education Act, or IDEA. President Bush signed the IDEA bill on December 3, 2004 and it became Public Law No: 108-446. The IDEA law is made up of four parts:

• Part A--General Provisions
• Part B--Assistance for Education of All Children With Disabilities
• Part C--Infants and Toddlers With Disabilities
• Part D--National Activities To Improve Education of Children With Disabilities

You can view the new IDEA law in its entirety or read "The NEW IDEA: CEC's Summary of Significant Issues" published by the Council for Exceptional Children.

Definitions and provisions of interest to school nurses include:

SEC. 602. DEFINITIONS

26) RELATED SERVICES-

(A) IN GENERAL - The term "related services" means transportation, and such developmental, corrective, and other supportive services (including speech-language pathology and audiology services, interpreting services, psychological services, physical and occupational therapy, recreation, including therapeutic recreation, social work services, school nurse services designed to enable a child with a disability to receive a free appropriate public education as described in the individualized education program of the child, counseling services, including rehabilitation counseling, orientation and mobility services, and medical services, except that such medical services shall be for diagnostic and evaluation purposes only) as may be required to assist a child with a disability to benefit from special education, and includes the early identification and assessment of disabling conditions in children.

(B) EXCEPTION - The term does not include a medical device that is surgically implanted, or the replacement of such device.

SEC. 612. STATE ELIGIBILITY

14) PERSONNEL QUALIFICATIONS-

(A) IN GENERAL - The State educational agency has established and maintains qualifications to ensure that personnel necessary to carry out this part are appropriately and adequately prepared and trained, including that those personnel have the content knowledge and skills to serve children with disabilities.

(B) RELATED SERVICES PERSONNEL AND PARAPROFESSIONALS - The qualifications under subparagraph (A) include qualifications for related services personnel and paraprofessionals that--

1. are consistent with any State-approved or State-recognized certification, licensing, registration, or other comparable requirements that apply to the professional discipline in which those personnel are providing special education or related services;
2. ensure that related services personnel who deliver services in their discipline or profession meet the requirements of clause (i) and have not had certification or licensure requirements waived on an emergency, temporary, or provisional basis; and
3. allow paraprofessionals and assistants who are appropriately trained and supervised, in accordance with State law, regulation, or written policy, in meeting the requirements of this part to be used to assist in the provision of special education and related services under this part to children with disabilities.

25) PROHIBITION ON MANDATORY MEDICATION-

(A) IN GENERAL - The State educational agency shall prohibit State and local educational agency personnel from requiring a child to obtain a prescription for a substance covered by the Controlled Substances Act (21 U.S.C. 801 et seq.) as a condition of attending school, receiving an evaluation under subsection (a) or (c) of section 614, or receiving services under this title.