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DISTRICT OF COLUMBIA PUBLIC SCHOOLS
NOTICE OF FINAL RULEMAKING
The Chancellor of the District of Columbia Public Schools (DCPS), pursuant to the authority set forth in sections 103(c)(2) and 105(c)(5) of the Public Education Reform Amendment Act of 2007 (“Act”), effective June 12, 2007 (D.C. Law 17-9, D.C. Official Code §§ 38-172 and 38-174), and Mayor’s Order 2007-186, dated August 10, 2007, hereby gives notice of her adoption of the addition of section 2413 to Chapter 24 (Student Rights and Responsibilities) of Subtitle B of Title 5 (District of Columbia Public Schools) of the District of Columbia Municipal Regulations (DCMR) upon the publication of this notice in the D.C. Register. The purpose of the amendment is to allow the Department of Health, the Department of Mental Health, and non-profit community-based health care providers to operate school health centers, to allow licensed providers in school-based health centers to dispense prescription and over-the-counter medications, and to clarify the role of school health centers in addressing the prevention of pregnancy and sexually-transmitted infections. The existing section 2413 of Chapter 24 of Subtitle E of Title 5 will also be repealed as part of this rulemaking.
These amendments were previously published as a proposed rulemaking in the D.C. Register at 56 DCR 6702 on August 22, 2009. DCPS considered all comments received, made changes to the proposed rulemaking, and published a second Notice of Proposed Rulemaking in the D.C. Register on June 4, 2010, at 57 DCR 4890. No substantive changes have been made to the text of the proposed rules as published. Additionally, the rulemaking was submitted to the Council for review through introduction of the School-Based Health Centers Regulations Approval Resolution of 2010, PR18-904, on June 4, 2010. The Council took no action on the rulemaking for forty-five days, and pursuant to section 103(c)(2) of the Act, the rulemaking was deemed approved.
A new section 2413 is added to Chapter 24 (Student Rights and Responsibilities) of Subtitle B of Title 5 DCMR (District of Columbia Public Schools) to read as follows:
2413 School-Based Health Centers
2413.1 The Chancellor may accept health services, including primary health, behavioral health, and oral health, from the Director of the Department of Health, the Director of the Department of Mental Health, or from a public or non-profit healthcare organization. The health services shall be provided to D.C. Public Schools students in a school setting in accordance with the provisions of this section, standards as established by the Department of Health, and an agreement concerning school-based health centers (SHCs) executed by the D.C. Public Schools (DCPS) and the healthcare organization.
2413.2 Health services provided to D.C. Public Schools pursuant to this section shall be provided to students in accordance with:
(a) The provisions of this section; and
(b) An agreement concerning SHCs executed by DCPS and the healthcare organization.
2413.3 Health services provided in a SHC located in DCPS shall be subject to the following limitations:
(a) Services shall augment, supplement, or complement DCPS services in the areas of the physical, social, mental, and emotional well-being of students, or fulfill an unmet health need within the general student population;
(b) A practitioner shall obtain informed consent for all health care services provided.
(c) Services shall be provided to:
(1) Students enrolled in the school in which the SHC is located;
(2) Additional schools named as part of the agreement executed between D.C. Public Schools and the healthcare organization;
(3) To students previously enrolled within those schools during the current school year, upon approval of the school principal;
(4) To prospective students of the schools as part of an enrollment process;
(5) To the students’ minor family members, upon approval by DCPS; and
(6) To other members of the community during before- or after-school hours, upon approval by DCPS.
(d) Services shall be provided regardless of ability to pay unless an agreement between DCPS and the healthcare organization provides otherwise. This section shall not be construed to relieve any insurer, Medicaid, or similar third party from an otherwise valid obligation to pay for these health services;
(e) Services shall be provided to minors pursuant to the consent requirements of sections 600 and 603 of Title 22 of the D.C. Municipal Regulations, and pursuant to D.C. Code §7-1231.14 for mental health treatment;
(f) Services shall be provided only during the hours between eight o’clock (8:00) a.m. and five o’clock (5:00) p.m., unless otherwise provided in an agreement between DCPS and the healthcare organization; and
(g) A notification system shall be established to inform students where to receive after-hours health care inclusive of non-school days, summer breaks, and during hours when the school-based health center can not be accessed.
(h) A practitioner in a school health center may dispense prescription and over-the-counter drugs, including contraceptive drugs and devices when medically indicated.
2413.4 Health care organizations providing services in a school health center shall be subject to the following requirements:
(a) Services shall be provided only by certified and licensed health professionals, acting under proper supervision, as appropriate;
(b) Services shall be provided only by government agencies or organizations that are licensed to provide primary health, behavioral health, or oral health services, as appropriate;
(c) Healthcare organization staff shall be subject to and shall pass the DC Public Schools background check and screening requirements required by the Criminal Background Checks for the Protection of Children Act of 2004, effective April 13, 2005 (D.C. Law 15-353); D.C. Official Code § 4-1 501.01 et seq.);
(d) The healthcare organization shall comply with the students’ health and personal confidentiality requirements of this chapter; the Family Educational Rights and Privacy Act (FERPA) approved (110 Stat 197) 20 U.S.C. § 1232g, and the regulations promulgated under FERPA, including 34 CFR Part 99; the Health Insurance Portability and Accountability Act (HIPAA) approved (110 Stat 2021) 42 U.S.C. § 1320d et seq., and the regulations promulgated under HIPAA, including 45 CFR Part 164; and the District of Columbia Mental Health Information Act of 1978, effective March 3, 1979 (D.C. Law 2-136; D.C. Official Code § 7-1201.01 et seq.); and
(e) The healthcare organization shall have insurance coverage for bodily injury and property damage, errors and omissions, officer’s liability and professional liability of no less than five million dollars ($5,000,000) per claim and ten million dollars ($10,000,000) per accident.
2413.5 A Local School Health Center Advisory Council (LSHCAC) shall be established at a school with a SHC. The school leadership may convene the LSHCAC as part of the school’s existing wellness council or committee. The LSHCAC shall serve in an advisory capacity to each SHC. The Chancellor shall make all decisions. The principal of each school with a SHC shall convene the initial meeting of that school’s LSHCAC. At the first meeting, the members present shall select the leadership of the council.
2413.6 Each LSHCAC shall be comprised of representatives from the local school staff, community leaders, health professionals, behavioral health and social work professionals, parents, and students. Each LSHCAC may also include representatives from the Office of the Chancellor and the Department of Health or the Department of Mental Health, as appropriate. The exact composition of each LSHCAC shall be determined by agreement executed among the school, DCPS, the Department of Health, the Department of Mental Health, and the healthcare organization.
2413.7 The LSHCAC shall provide advice to the local school administration, the Directors of the Departments of Health and Mental Health, and the Chancellor on matters related to the operation of the school health center as it considers appropriate. It shall specifically advise on the following:
(a) The standard format and procedures used to inform parents of the school health center and to gain their consent for utilization of the center by their children;
(b) The scope of services provided at the health center;
(c) The adequacy of the health education material used to promote preventive health care and general health promotion;
(d) The adequacy of any school health center’s provisions to enhance and encourage parents’ ability to counsel their own children with competence and confidence;
(e) The consistency of the health education materials regarding human sexuality, preventive health care, and general health promotion with materials used in the classroom; and
(f) The adequacy of a SHC’s provisions for addressing the emotional and social support needs of students.
A new section 2499 (Definitions) is added to Subtitle B of Title 5 to read as follows:
2499 Definitions
2499.1 Reserved
2499.2 When used in this chapter, the following terms shall have the meanings ascribed:
Chancellor—the Chancellor of the District of Columbia Public Schools.
D.C. Public Schools or DCPS—the public school system excluding public charter schools.
Healthcare organization—a licensed primary health, behavioral health, or oral health provider that sponsors a SHC in a particular DCPS school.
Practitioner—a person licensed, registered, certified, or otherwise permitted by law to prescribe, dispense, and administer drugs or medical devices, within the course of the person’s professional practice.
School-based health center or SHC—a primary health or behavioral health care facility established and operated within a public school building or on the grounds of a public school by the Department of Health, the Department of Mental Health, or by a public, for profit, or non-profit healthcare entity or provider under a written agreement with the Chancellor.
Section 2413 of Chapter 24 of Subtitle E of Title 5 (Education, Original Title 5) is repealed.
