Summary of All Health Requirements for Public Schools in Ohio and Their Guaranteed Exemptions
Untangling the Net of Authorizations, Requirements, Permissions and Exemptions of Ohio’s Health Requirement Laws for Public Schools
Disclaimer
The contributing author for this article is not an attorney and is not authorized to practice law in Ohio. Nothing presented in this document is to be taken as legal advice. Everything presented here is personal opinion derived from extensive research and is for informational purposes only. Feel free to contact The Center for more information.
Introduction
The laws for Ohio public schools that require physical exams, testing, screening for incoming kindergartners and first graders and immunizations for students in all grades are quite confusing. Many board members and school officials are not quite clear themselves. Therefore this reference was created specifically with board members and school administration in mind to consult as well as the general public for clarity on the matter. Below, each law is listed indicating the authority granted, the specific requirement, the due date and the exemption if one applies. For a deeper discussion on why there are exemptions to each of the health requirements below, please see article All Health “Requirements” for Ohio Public Schools Are Optional. If you feel this article has provided value for the public, please consider subscribing to support and sharing with others you think might find the information useful.
ORC 3313.50 | Record of tests - statistical data - individual records.
Authority: Keep records of pupil health information
Requirement: Must keep accurate records for hearing and vision
ORC 3313.535 | Standards for participation in interscholastic extracurricular activities.
Authority: To make and enforce rules regarding extracurricular sports
Requirement
Shall
Adopt rules regarding students maintaining grades for sports
Adopt policy prohibiting students with failing grades from participating
Adopt rules for additional standard for determining eligibility
Notes:
There is no physical exam required for extracurricular sports by Ohio law
Your school is likely a member of OHSAA.
OHSAA bylaws 3-5-1 through 3-5-3 require a physical exam for participation and state that ORC 3313.73 (described below) allows for any parent to refuse any medical exam or treatment, but they then go on to advise schools that “nothing in Section 3313.73 of the ORC would preclude a school from adopting a Board of Education policy that would deny participation in interscholastic athletics for any student whose parent or guardian refuses a physical exam.”
Districts appear to be using 3313.353(D) as the specific authority to require this physical exam in the following policies:
NEOLA 2431 & 5310
OSBA JHCA
P&W 7.19
Current policy for all schools who are members of OHSAA allow for denial to participate in extracurricular sports without a physical exam.
ORC 3313.539 | Concussions and school athletics.
Authority: To make and enforce rules regarding concussions
Requirement:
Must provide information to parents regarding concussions when participating in extracurricular non graded curriculum sports.
Coaches and referees must hold “pupil-activity program permit”
If a student is removed from practice or competition by ref or coach, they cannot return the same day.
Cannot return afterwards until assessed by a physician.
Exemption: none
ORC 3313.67 | Immunization of pupils (1)
Authority:
“[to] make and enforce such rules to secure the immunization of, and to prevent the spread of communicable diseases.”
Requirement:
Must keep a record of
Immunizations mentioned in 3313.671.
Tuberculosis tests, if given according to 3313.71.
Any other immunization required by the board.
Permissions
May require immunizations other than those required by 3313.671
Exemption:
Must be consistent with 3313.671 (which documents the right to an exemption).
Due Date:
Must report immunization records to director of health by 15th of Oct
ORC 3313.671 | Immunizations - exceptions (2)
Authority: Derived from 3313.67(A) requirement to enforce rules for immunization
Requirement:
Must keep a record of immunizations from 3313.67
Must exclude students from school if not immunized within 14 days
Or, if in the process of being immunized, must be excluded if not being immunized at the intervals prescribed by the director of health
Must provide immunizations for pupils if parents/guardians aren’t able to provide
Permissions:
May exclude a child not immunized for chicken pox during an outbreak but must preserve the academic standing of the pupil
Exemptions:
Any parent or guardian
Attests to natural immunity for rubeola, mumps or chickenpox
Submits physician’s certification of contraindication
Declines in writing citing “reasons of conscience, including religious convictions”
Cannot be scrutinized or denied; must be honored, is automatic upon submission.
Due Date: Within 14 days of initial entry
ORC 3313.673 | Special Needs Screenings (3)
Authority: To conduct screenings
Requirement:
“The pupil shall be screened for hearing, vision, speech and communications, and health or medical problems and for any developmental disorders.”
“If the board conducts hearing and vision screening itself or contracts for hearing and vision screening, such screening shall be conducted pursuant to sections
Permissions
“The [1] board may provide any of the elements of the screening program itself, [2] contract with any person or governmental entity to provide any such elements, or request the parent to obtain any such elements from a [3] provider selected by the parent”
Board provides:
See 3313.69 below
Exemption: Parents can decline any exam or treatment in writing, no reason needed, must be accepted.
Contracts with governmental entity:
See 3313.73 below
Exemption: Parents can decline any exam or treatment, no reason needed, must be accepted.
Requests parents to use own provider:
Exemption: Parents can give a written statement to refuse, no reason needed, must be accepted.
Exemption
Parent only needs to decline in writing. Cannot be scrutinized, overruled; must be honored, Is automatic upon submission.
Due Date: prior to the first day of November of the school year in which a pupil is enrolled for the first time in either kindergarten or first grade
ORC 3313.674 | BMI and Weight Screening (4)
Authority: To conduct screenings
Requirement: None; it is at The Board’s discretion.
Permissions: The Board may require each student enrolled in kindergarten, third grade, fifth grade, and ninth grade to undergo a screening for body mass index and weight status category.
Exemption: Parents can opt out with a written statement, no reason needed, cannot be refused, automatic upon submission.
ORC 3313.68 | Employment of School Physicians (5)
Authority:
To hire physicians, dentists,and registered nurses; duties prescribed by law (see 3313.69 and 3313.71).
To require dentists conduct dental or oral exams.
Requirement:
“Boards… shall cooperate with boards of health in the prevention and control of epidemics”
Permissions
Boards may direct school dentists to examine and diagnose students; treatments only to be done on children whose parents cannot afford.
The Board may delegate such powers to the local board of health.
The Board may contract with local ESC for school nurse services for diabetes care, see ORC 3313.7112.
The Board may contract with a hospital; see ORC 3313.721.
Exemption: Dental treatments must have written consent of parents.
ORC 3313.69 | Hearing and visual tests of school children - exemptions. (6)
Authority:
To conduct hearing, vision, medical and dental exams.
Requirement:
If a board hires a physician and/or a dentist and will be conducting its own physical and dental exams as authorized in 3313.68, hearing and vision screening must be included.
Exemptions:
Since the authority for vision and hearing screenings is derived from 3313.673, the exemptions carry over as well despite the fact that they are not mentioned specifically in this law. The Ohio Department of Health confirms these exemptions by providing sample waiver letters; parents are not required to give reason; the exemption cannot be scrutinized or refused; it is automatic upon submission
ODH Summary of hearing screening requirements provides a sample waiver letter for parents to sign (Letter C, pg 22) to exempt children.
ODH Summary of visual screening requirements provides a sample waiver letter for parents to sign (Letter E, pg 93) to exempt children.
ORC 3313.69 does not appear to have a guaranteed exemption for dental inspections. However, the Ohio Department of Health declares that dental exams are optional and that parental permission must be obtained for the exam which makes it consistent with all other health requirements.
ODH Oral Health Screening Guidelines mentions that screenings are optional on pg. 1 and that schools must obtain parental permission on pg. 4
Due Date: See ORC 3313.673 for vision and hearing
ORC 3313.71 | Examinations and diagnoses by school physician (7)
Authority:
School physicians providing medical care under 33313.68 are authorized to diagnose all children referred to them and conduct hearing tests.
Requirement:
Boards of education shall require and provide, in accordance with section 3313.67 of the Revised Code, such tests and examinations for tuberculosis of pupils in selected grades and of school employees as may be required by the director of health. So, the director of health determines the requirement. Currently, there is no such requirement that has been issued by the health director.
Students testing positive for tuberculosis can only return to school after being examined by a physician.
Exemption:
If required, parents can decline tuberculosis tests for religious convictions, which may not be scrutinized or refused; automatic upon submission.
Due Date: by the 15th of October
ORC 3313.712 | Emergency medical authorization.
Requirement: Schools must provide form for parent authorization.
Note: Even if authorized, must make attempts to contact parent or guardian before treatment
Due Date: before the first day of October
ORC 3313.713 | District prescription drug distribution policy.
Prohibitions: No employee shall use certain procedures, such as injection, to administer a drug to a student.
Exemption: Must have parental written request.
ORC 3313.714 - Medicaid Healthcheck Program
Exemption: Must have parental consent for any examinations.
Note: But, if parents are given notice of the exam and they don’t respond within two weeks, they are deemed to have given consent.
ORC 3313.715 | District may request Medicaid Numbers
Permission: School may request numbers directly from Medicaid by providing names of students.
ORC 3313.716 | Possession and use metered dose inhaler or dry powder inhaler to alleviate asthmatic symptoms
Requirement: Students may not possess unless they have written approval from physician and parent/guardian.
ORC 3313.717 | Placement of automated external defibrillator in schools
Permission: To be used in emergencies, no parental consent required.
ORC 3313.718 | Possession and use of epinephrine autoinjector to treat anaphylaxis
Requirement: Students may not possess autoinjectors withpit written approval from parent/guardian and physician.
ORC 3313.719 | Food allergy protection policy.
Requirement: Training for how to assist individual experiencing allergic reaction.
Note: Training instructs student how to administer epinephrine.
ORC 3313.7110 | Procurement of epinephrine autoinjectors for public schools
Requirements:
Schools required to maintain at least two injectors.
Must designated trained individuals who can use them.
ORC 3313.72 | School Board Contracts With Local Board of Health
Authority: Authorizes boards to contract with health district to provide services of physician, dentist or nurse
Requirement: None; Contractual
Exemption: Exemption guaranteed in 3313.73
ORC 3313.73 | Examinations Done by Local Board of Health (8)
Authority: Authorizes board of health to conduct health exams
Requirement: None
Exemption: Parents may object to any medical examination or treatment
ORC 3709.22. Duties of board of city or general health district (9)
Authority: Authorizes board of health to perform medical or surgical treatments
Exemption: Parents must request medical treatments in writing
Summary:
There are twenty one laws related to medical tests, exams, screenings or immunizations, or authorization to dispense drugs or medically related equipment or use emergency equipment or implement emergency care.
Two of them are for extracurricular activities that are not part of the graded curriculum and therefore are not required for attending school.
The remaining 19 are either for requirements for the graded curriculum or requirements for the school to obtain parent authorization to dispense drugs or medical equipment or to implement emergency treatments.
Nine of these laws (indicated above) specifically deal with the requirements for tests, screening immunizations or exams and all of them guarantee exemptions to all of the requirements.
The director of health (Ohio Department of Health) has ultimate authority over the following medical requirements:
Whether or not tuberculosis tests will be required according to 3313.71;
What the approved methods of immunization are according to 3313.671(A)(1);
Determines the intervals for a student who is in the process of being immunized; according to 3313.671(A)(4).
Determines how vision and hearing test records are kept according to 3313.50
Only one law, ORC 3313.71, regarding tuberculosis testing, requires the parent or guardian to declare a “religious objection” when declaring their exemption, which can’t be scrutinized and is guaranteed.
Only one law, ORC 3313.671 regarding immunizations, requires the parent or guardian to declare a “reason of conscience” which could include a “religious objection” when declaring their exemption, which can’t be scrutinized and is guaranteed.
One law, ORC 3313.68 regarding dental treatments, requires parental or guardian to consent in writing prior to giving treatment.
Regarding physical exams or other screenings, the five laws ORC 3313.673, ORC 3313.674, ORC 3313.69, 3313.72 and ORC 3709.22 only require the parent to decline in writing, no reason needed.
None of these medical requirements are required to be completed at enrollment. In fact, they apply to students who are already enrolled or after the school year has begun. But, districts often leverage enrollment to ensure that all of these requirements are met in an as efficient way as possible. Therefore, any parent or guardian that wishes to exercise any of the exemptions should be prepared to do so at enrollment.
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