House Bill 0855
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
By Representatives Minton and Betancourt
1 A bill to be entitled
2 An act relating to school health services;
3 providing a short title; amending s. 381.0056,
4 F.S.; defining the term "entity" or "health
5 care entity"; requiring that certain services
6 be documented in a local school health services
7 plan; specifying that certain persons be
8 considered agents of the state for purposes of
9 sovereign immunity when rendering specified
10 services; creating s. 381.0058, F.S., relating
11 to public-private partnerships for the
12 provision of school nurse services; providing
13 legislative intent and purpose; providing
14 departmental duties; providing a proposal
15 submission and review process; providing for
16 the scope of services to be provided; providing
17 for review and selection criteria; creating s.
18 381.0059, F.S., relating to background
19 screening requirements for school health
20 services providers; specifying the persons who
21 must submit to such screening; specifying
22 payment for screening services; providing
23 grounds for disqualification; requiring certain
24 attestation to screening requirements;
25 directing the Department of Health to determine
26 a means by which certain units of local
27 government may receive a designation for
28 purposes of federal Title V programs; requiring
29 a study of training requirements for school
30 health nurses; providing legislative intent
31
1
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 relating to funding of the act; providing
2 appropriations; providing an effective date.
3
4 Be It Enacted by the Legislature of the State of Florida:
5
6 Section 1. This act may be cited as the "One School,
7 One Nurse Act."
8 Section 2. Section 381.0056, Florida Statutes, is
9 amended to read:
10 381.0056 School health services program.--
11 (1) This section may be cited as the "School Health
12 Services Act."
13 (2) The Legislature finds that health services
14 conducted as a part of the total school health program should
15 be carried out to appraise, protect, and promote the health of
16 students. School health services supplement, rather than
17 replace, parental responsibility and are designed to encourage
18 parents to devote attention to child health, to discover
19 health problems, and to encourage use of the services of their
20 physicians, dentists, and community health agencies.
21 (3) When used in this section:
22 (a) "Emergency health needs" means onsite management
23 and aid for illness or injury pending the student's return to
24 the classroom or release to a parent, guardian, designated
25 friend, or designated health care provider.
26 (b) "Entity" or "health care entity" means a unit of
27 local government or a political subdivision of the state; a
28 hospital licensed under chapter 395; a health maintenance
29 organization certified under chapter 641; a health insurer
30 authorized under the Florida Insurance Code; a community
31 health center; a migrant health center; a federally qualified
2
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 health center; an organization that meets the requirements for
2 nonprofit status under section 501(c)(3) of the Internal
3 Revenue Code; a private industry or business; or a
4 philanthropic foundation that agrees to participate in a
5 public-private partnership with a county health department,
6 local school district, or school in the delivery of school
7 health services, and agrees to the terms and conditions for
8 the delivery of such services as required by this section and
9 as documented in the local school health services plan.
10 (c)(b) "Invasive screening" means any screening
11 procedure in which the skin or any body orifice is penetrated.
12 (d)(c) "Physical examination" means a thorough
13 evaluation of the health status of an individual.
14 (e)(d) "School health services plan" means the
15 document that describes the services to be provided, the
16 responsibility for provision of the services, the anticipated
17 expenditures to provide the services, and evidence of
18 cooperative planning by local school districts and county
19 health departments.
20 (f)(e) "Screening" means presumptive identification of
21 unknown or unrecognized diseases or defects by the application
22 of tests that can be given with ease and rapidity to
23 apparently healthy persons.
24 (4) The Department of Health shall have the
25 responsibility, in cooperation with the Department of
26 Education, to supervise the administration of the school
27 health services program and perform periodic program reviews.
28 However, the principal of each school shall have immediate
29 supervisory authority over the health personnel working in the
30 school.
31
3
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 (5) Each county health department shall develop,
2 jointly with the district school board and the local school
3 health advisory committee, a school health services plan; and
4 the plan shall include, at a minimum, provisions for:
5 (a) Health appraisal;
6 (b) Records review;
7 (c) Nurse assessment;
8 (d) Nutrition assessment;
9 (e) A preventive dental program;
10 (f) Vision screening;
11 (g) Hearing screening;
12 (h) Scoliosis screening;
13 (i) Growth and development screening;
14 (j) Health counseling;
15 (k) Referral and followup of suspected or confirmed
16 health problems by the local county health department;
17 (l) Meeting emergency health needs in each school;
18 (m) County health department personnel to assist
19 school personnel in health education curriculum development;
20 (n) Referral of students to appropriate health
21 treatment, in cooperation with the private health community
22 whenever possible;
23 (o) Consultation with a student's parent or guardian
24 regarding the need for health attention by the family
25 physician, dentist, or other specialist when definitive
26 diagnosis or treatment is indicated;
27 (p) Maintenance of records on incidents of health
28 problems, corrective measures taken, and such other
29 information as may be needed to plan and evaluate health
30 programs; except, however, that provisions in the plan for
31
4
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 maintenance of health records of individual students must be
2 in accordance with s. 228.093;
3 (q) Health information which will be provided by the
4 school health nurses, when necessary, regarding the placement
5 of students in exceptional student programs and the
6 reevaluation at periodic intervals of students placed in such
7 programs; and
8 (r) Notification to the local nonpublic schools of the
9 school health services program and the opportunity for
10 representatives of the local nonpublic schools to participate
11 in the development of the cooperative health services plan.
12 (6) A nonpublic school may request to participate in
13 the school health services program. A nonpublic school
14 voluntarily participating in the school health services
15 program shall:
16 (a) Cooperate with the county health department and
17 district school board in the development of the cooperative
18 health services plan;
19 (b) Make available adequate physical facilities for
20 health services;
21 (c) Provide inservice health training to school
22 personnel;
23 (d) Cooperate with public health personnel in the
24 implementation of the school health services plan;
25 (e) Be subject to health service program reviews by
26 the Department of Health and the Department of Education; and
27 (f) At the beginning of each school year, inform
28 parents or guardians in writing that their children who are
29 students in the school will receive specified health services
30 as provided for in the district health services plan. A
31 student will be exempt from any of these services if his or
5
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 her parent or guardian requests such exemption in writing.
2 This paragraph shall not be construed to authorize invasive
3 screening; if there is a need for such procedure, the consent
4 of the student's parent or guardian shall be obtained in
5 writing prior to performing the screening. However, the laws
6 and rules relating to contagious or communicable diseases and
7 sanitary matters shall not be violated.
8 (7) The district school board shall:
9 (a) Coordinate the educational aspects of the school
10 health services program with the Florida Comprehensive Health
11 Education and Substance Abuse Prevention Act;
12 (b) Include health services and health education as
13 part of the comprehensive plan for the school district;
14 (c) Provide inservice health training for school
15 personnel;
16 (d) Make available adequate physical facilities for
17 health services; and
18 (e) At the beginning of each school year, inform
19 parents or guardians in writing that their children who are
20 students in the district schools will receive specified health
21 services as provided for in the district health services plan.
22 A student will be exempt from any of these services if his or
23 her parent or guardian requests such exemption in writing.
24 This paragraph shall not be construed to authorize invasive
25 screening; if there is a need for such procedure, the consent
26 of the student's parent or guardian shall be obtained in
27 writing prior to performing the screening. However, the laws
28 and rules relating to contagious or communicable diseases and
29 sanitary matters shall not be violated.
30
31
6
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 (8) The Department of Health, in cooperation with the
2 Department of Education, may adopt rules necessary to
3 implement this section.
4 (9) In the absence of negligence, no person shall be
5 liable for any injury caused by an act or omission in the
6 administration of school health services.
7 (10) Any person who provides services under a school
8 health services plan developed under this section and who is
9 the employee or agent of a health care entity that has agreed,
10 in writing, to act on behalf of the state as an agent of the
11 Department of Health to provide school health services, with
12 or without compensation, is, solely with respect to such
13 services, an agent of the state for purposes of s. 768.28.
14 Section 3. Section 381.0058, Florida Statutes, is
15 created to read:
16 381.0058 Matching funds for school nurse services
17 public-private partnerships.--
18 (1) It is the intent of the Legislature that matching
19 funds, in addition to those provided under s. 381.0056 for the
20 School Health Services Act and s. 381.0057 for school health
21 services funding, be provided in those communities where
22 interest in school health services is evidenced by the
23 participation of public or private entities in the funding or
24 delivery of school nurse services. The purpose of this funding
25 is to encourage the development of those programs that offer
26 the greatest potential for promoting the health of students,
27 increasing the availability of and access to nurses in the
28 school setting, and fostering greater community participation
29 in the delivery of school nurse services. Matching funds shall
30 be available specifically for implementation of programs as
31 described in ss. 381.0056, 381.0057, and 402.3026, and that
7
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 are designed to meet the particular needs of the community.
2 Further, it is the intent of the Legislature that
3 tobacco-settlement revenue be used to pay for health and human
4 services for children.
5 (2) The Secretary of Health, or his or her designee,
6 in cooperation with the Commissioner of Education, or his or
7 her designee, shall publicize the availability of matching
8 funds for public and private entities committed to enhancing
9 the availability of school nurse service, as reflected in
10 formal agreements that are part of the local school health
11 services plan.
12 (3) The Secretary of Health, or his or her designees,
13 in cooperation with the Commissioner of Education, or his or
14 her designees, in equal representation, shall form a committee
15 to determine the eligibility of sites to receive matching
16 funds.
17 (4) Any community that seeks to receive state matching
18 funds under this section must submit a proposal to the
19 committee established in subsection (3). The proposal must
20 state the goals of the program, provide specific plans for
21 enhancing local resources available for school nurse services,
22 and describe all of the health services to be made available
23 to students from matching funds provided under this section. A
24 county health department or school district receiving matching
25 funds may not supplant more than 50 percent of the current
26 local contributions to school health services funding, as
27 documented in the local school health services plan.
28 (5) In addition to the merits of a proposal, the award
29 of matching funds must be based on those proposals from sites
30 that include county health departments and school districts
31 that most closely meet the following criteria:
8
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 (a) Have evidence of a comprehensive inservice staff
2 development plan.
3 (b) Have evidence of a cooperative working
4 relationship between the county health department and the
5 school district and have community as well as parental
6 support.
7 (c) Have a high percentage of subsidized school
8 lunches.
9 (d) Have a high incidence of medically underserved
10 high-risk children, low-birthweight babies, infant mortality,
11 or teenage pregnancy.
12 (e) Have a high incidence of children with chronic
13 health conditions or high-risk behavioral problems.
14 (f) Have documented in the local school health
15 services plan a commitment from community entities to fund or
16 provide other direct resources for the enhanced availability
17 of school health services.
18 (g) Have a plan to ensure billing for Medicaid funding
19 for services rendered under the certified school match program
20 or the county health department certified match program as
21 specified in s. 409.9122.
22
23 While these criteria are part of the proposal review process,
24 these criteria are not to be construed as the sole factors to
25 be considered in the proposal review process. The ability and
26 interest of a site in addressing locally identified needs and
27 priorities must also be considered. In addition, receipt of
28 matching funds is not intended to diminish a site's
29 eligibility for base funding for school health services.
30 Section 4. Section 381.0059, Florida Statutes, is
31 created to read:
9
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 381.0059 Background screening requirements for school
2 health services personnel.--
3 (1)(a) Any person who provides services under a school
4 health services plan pursuant to s. 381.0056 must complete
5 level 2 screening as provided in chapter 435. A person may
6 satisfy the requirements of this subsection by submitting
7 proof of compliance with the requirements of level 2 screening
8 under s. 435.04, conducted within 12 months before the date
9 that person initially provides services under a school health
10 services plan pursuant to s. 381.0056. Any person who provides
11 services under a school health services plan pursuant to s.
12 381.0056 shall be on probationary status pending the results
13 of the level 2 screening.
14 (b) In order to conduct level 2 screening, any person
15 who provides services under a school health services plan
16 pursuant to s. 381.0056 must furnish to the Department of
17 Health a full set of fingerprints to enable the department to
18 conduct a criminal background investigation. Each person who
19 provides services under a school health services plan pursuant
20 to s. 381.0056 must file a complete set of fingerprints taken
21 by an authorized law enforcement officer and must provide
22 sufficient information for a statewide criminal records
23 correspondence check through the Florida Department of Law
24 Enforcement. The Department of Health shall submit the
25 fingerprints to the Florida Department of Law Enforcement for
26 a statewide criminal history check, and the Florida Department
27 of Law Enforcement shall forward the fingerprints to the
28 Federal Bureau of Investigation for a national criminal
29 history check.
30 (c) The person subject to the required background
31 screening or his or her employer must pay the fees required to
10
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 obtain the background screening. Payment for the screening and
2 the abuse registry check must be submitted to the Department
3 of Health. The Florida Department of Law Enforcement shall
4 charge the Department of Health for a level 2 screening at a
5 rate sufficient to cover the costs of such screening pursuant
6 to s. 943.053(3). The Department of Health shall establish a
7 schedule of fees to cover the costs of the level 2 screening
8 and the abuse registry check. The applicant or his or her
9 employer who pays for the required screening may be reimbursed
10 by the Department of Health from funds designated for this
11 purpose.
12 (2)(a) When the Department of Health has reasonable
13 cause to believe that grounds exist for the disqualification
14 of any person providing services under a school health
15 services plan pursuant to s. 381.0056, as a result of
16 background screening, it shall notify the person in writing,
17 stating the specific record that indicates noncompliance with
18 the level 2 screening standards. The Department of Health must
19 disqualify any person from providing services under a school
20 health services plan pursuant to s. 381.0056 if the department
21 finds that the person is not in compliance with the level 2
22 screening standards. A person who provides services under a
23 school health plan pursuant to s. 381.0056 on a probationary
24 status and who is disqualified because of the results of his
25 or her background screening may contest that disqualification.
26 (b) As provided in s. 435.07, the Department of Health
27 may grant an exemption from disqualification to a person
28 providing services under a school health services plan
29 pursuant to s. 381.0056 who has not received a professional
30 license or certification from the Department of Health.
31
11
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 (c) As provided in s. 435.07, the Department of Health
2 may grant an exemption from disqualification to a person
3 providing services under a school health services plan
4 pursuant to s. 381.0056 who has received a professional
5 license or certification from the Department of Health.
6 (3) Any person who is required to undergo the
7 background screening to provide services under a school health
8 plan pursuant to s. 381.0056 who refuses to cooperate in such
9 screening or refuses to submit the information necessary to
10 complete the screening, including fingerprints, shall be
11 disqualified for employment or volunteering in such position
12 or, if employed, shall be dismissed.
13 (4) Under penalty of perjury, each person who provides
14 services under a school health plan pursuant to s. 381.0056
15 must attest to meeting the level 2 screening requirements for
16 participation under the plan and agree to inform the
17 Department of Health immediately if convicted of any
18 disqualifying offense while providing services under a school
19 health services plan pursuant to s. 381.0056.
20 Section 5. Subsection (20) is added to section 768.28,
21 Florida Statutes, 1998 Supplement, to read:
22 768.28 Waiver of sovereign immunity in tort actions;
23 recovery limits; limitation on attorney fees; statute of
24 limitations; exclusions; indemnification; risk management
25 programs.--
26 (20)(a) A health care provider, or any employee or
27 agent of a health care entity, who has contractually agreed to
28 act on behalf of the state as an agent of the Department of
29 Health to provide school health services pursuant to s.
30 381.0056, with or without compensation, is, solely with
31 respect to such services, an agent of the state for purposes
12
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 of this section while acting within the scope of his or her
2 license, acting under the supervision of the county health
3 department, and acting pursuant to guidelines established in
4 the school health services plan. For purposes of this
5 subsection, the partnership agreements documented in the
6 school health services plan developed by the county health
7 department and district school board under s. 381.0056,
8 including related contracts and memoranda of agreement,
9 constitute a contract. Such contract must provide for the
10 indemnification of the state by the agent for any liabilities
11 incurred, up to the limits specified in this chapter.
12 (b) This subsection does not designate a person who is
13 not an employee of a unit of government and who provides
14 school health services as an employee or agent of the state
15 for purposes of chapter 440.
16 Section 6. The Department of Health shall explore,
17 with the federal Department of Health and Human Services, ways
18 by which units of local government, other than county health
19 departments, which participate in a school nurse services
20 public-private partnership developed under section 381.0058,
21 Florida Statutes, may be entitled to designation as Title V
22 (Maternal and Child Health Block Grant) agencies. If the
23 federal Department of Health and Human Services approves, the
24 department shall adopt by rule the criteria and guidelines
25 necessary to ensure oversight, flexibility, and accountability
26 for purposes of granting such a designation. This designation
27 is not intended to obligate any direct funding to the
28 designated entity from the Title V funds of the Department of
29 Health. Any money earned from Medicaid by such a designated
30 entity must be reinvested in the school nurse services
31 public-private partnership.
13
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 Section 7. The Department of Health shall study the
2 feasibility of requiring additional training for nurses
3 providing school health services. The Secretary of Health
4 shall appoint two representatives from each of the following
5 entities to serve on a study group: the Department of Health;
6 the Department of Education; the Florida Nurses Association;
7 the State University System; and the Board of Nursing. The
8 Secretary of Health shall appoint a member of the study group
9 to serve as chair. Members of the study group shall serve
10 without compensation but are entitled to reimbursement from
11 existing resources of their employing organization for per
12 diem and travel expenses incurred in the performance of their
13 duties, as provided in section 112.061, Florida Statutes. The
14 study group shall ascertain which services are being rendered
15 and which aspects of these services are sufficiently unique to
16 justify specific training in preparation for the delivery of
17 such services; the appropriate duration for and content of a
18 training curriculum for school health nurses; the costs and
19 availability of training programs and resources for such
20 training programs; the number of nurses currently employed in
21 a school health capacity and whether these nurses require
22 additional training or should be grandfathered-in; the factors
23 that motivate nurses to seek such additional training; and any
24 existing national training programs and their suitability for
25 application in this state. The department shall report the
26 findings and recommendations of the work group to the
27 Governor, the President of the Senate, and the Speaker of the
28 House of Representatives by February 1, 2000.
29 Section 8. Legislative intent; funding.--It is the
30 intent of the Legislature that sufficient resources be made
31 available to fund a nurse in every public school in the state,
14
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 pursuant to this act. The Legislature recognizes that
2 extensive resources will be necessary to achieve this intent,
3 and that a portion of these resources can be found from a
4 variety of existing resources. The Legislature recognizes that
5 existing funding for basic and comprehensive school health
6 services and full service schools, as created under sections
7 381.0056 and 381.0057, Florida Statutes, can be used as
8 partial funding. The Legislature further recognizes that
9 funding earned by local school districts and county health
10 departments from the Agency for Health Care Administration
11 from the delivery of services to Medicaid-eligible students
12 can also be used as partial funding. Finally, the Legislature
13 recognizes that another source of funding is local funding
14 currently being used for school health services, which can now
15 be eligible for matching funds under school nurse services
16 public-private partnerships as created by this act. It is the
17 intent of the Legislature that the remainder of resources
18 necessary for placing a nurse in every school will need to be
19 derived from the state's tobacco settlement revenue.
20 Section 9. The sum of $75,000 is appropriated from
21 nonrecurring General Revenue to the Department of Health for
22 the purpose of convening a school health summit as recommended
23 by Senate Interim Project Report 98-30, September 1998.
24 Section 10. This act shall take effect July 1, 1999.
25
26
27
28
29
30
31
15
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 855
541-151-99
1 *****************************************
2 SENATE SUMMARY
3 Revises provisions related to school health services
programs. Provides legislative intent and guidelines to
4 publicize and make available matching funds for school
nurse services public-private partnerships. Establishes
5 background screening requirements for school health
services personnel. Provides a waiver of sovereign
6 immunity relating to tort actions relating to certain
health care providers or entities that are acting on
7 behalf of the state in providing school health services.
Requires the Department of Health to explore means
8 through which certain local governments can participate
in school nurse services public-private partnerships.
9 Requires a study of the need for additional training for
school health services nurses. Provides for funding such
10 programs and provides an appropriation. (See bill for
details.)
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
16