Since 1991, the Code of Maryland Regulations COMAR 13A.05.05.05 - .15 mandated health coverage in schools by a school health services professional. The school health services professional is defined in COMAR as a physician, certified nurse practitioner, or registered nurse, with experience and or training in working with children or school health programs. Local school systems, with the assistance of local health departments, are responsible for providing school health services to all public schools. The regulations do not specify a ratio of school nurse to student.
Local jurisdictions in Maryland meet the mandate in a variety of ways. Some have a registered nurse in every school; others employ licensed practical nurses or registered nurses in each school. In some schools, trained unlicensed health staff are in each school working under the supervision of a registered nurse who may be responsible for one to three schools. Either local school systems or local health departments manage school health services programs. School nurses work with students, family, health care providers and school staff to support student success.
School nurses support student success. They are an integral part of school multi-disciplinary teams, bridging the gap between health and wellness and learning. School nurses identify student health-related concerns and makes accommodations and/or interventions to supports learning. They also focus on early detection and correction of health problems. School nurses promote and protect the optimal health of students. They work with families and students to develop individualized health care plans for students with special health needs. They provide health counseling to students and their families, as well as school staff. They identify and report school environmental concerns. They determine which nursing services can be delegated, and provide supervision for the one to whom he or she delegates.
The Annotated Code of Maryland Education Law §7-403 mandates an immunization program for children entering schools.
The Annotated Code of Maryland Education Article § 7-402 requires physical examinations for children entering the Maryland public school system for the first time. The examination must be completed in the nine-month period before entering the public school system or in the six-month period after entering the school system.
The Annotated Code of Maryland Education Article § 7-404 (hearing and vision) mandates screening tests for students in public schools. The hearing and vision screenings are required in the year that a student enters a school system, enters the first grade, and enters the eighth or ninth grade.
When there is a need for a student to receive medication in school, safe and proper administration is essential. The Maryland Department of Education and the Maryland Department of Health and Mental Hygiene, and the Maryland State School Health Council has developed guidelines to assist local school systems and local health departments in the development of their medication administration policies. An authorized prescriber must order all prescription medication and over-the counter medications to be given in school. Consult with the local school health services program for information on the medication administration policy.
Each local school system has procedures for controlling head lice. Consult with the school health services staff regarding the local policies for head lice.
To learn more about school health services, contact Alicia Mezu, Health Services Specialist, at (410) 767-0353 or e-mail at
firstname.lastname@example.org. You can also contact the Health Services Specialists by writing to Maryland State Department of Education, Student Services and Alternative Programs Branch, 200 West Baltimore Street, Baltimore, Maryland 21201.
200 West Baltimore Street, Baltimore, MD 21201-2595
410-767-0100 • 1-888-246-0016
© 2019 Maryland State Department of Education