Health Services

Education Law 912 requires each of the school districts in New York State to provide resident students who attend religious and independent schools with all of the same health and welfare services available to students who attend the public schools of the district. The administrators of religious and independent schools must request these services which include, but are not limited to, all of the services performed by a physician, dentist, dental hygienist, school nurse, school psychologist, school social worker and speech language pathologist. The services also may include dental prophylaxis; vision, hearing and scoliosis screening tests; recording health histories; physical examinations and in-school immunization; maintaining cumulative health records; and administering emergency care programs for ill or injured students. These services must be provided by the school district in which the school is located.

In New York City, the aforementioned health services are provided by the New York City Department of Education’s (“NYCDOE”) Office of School Health.

In cases where students attending a religious or independent school reside in another public school district, the two public school districts must enter into a written contract governing the services to be provided and the reimbursement for such services.

1. The school health services that are required to be provided by each school district (except NYCDOE) are outlined in Article 19 of Education Law and Commissioner’s Regulation section 136.3.These requirements include, but are not limited to: (1) physical examinations upon entrance to school and in grades pre-K or K,1,3,5,7,9, & 11 and at any other time deemed necessary by school authorities in the educational interests of the student; A school must request a dental health certificate at the time a health exam is required. (2) a vision screening test for all students upon entrance to school and in grades pre-K or K,1,3,5,7,&11; (3) a hearing screening test for all students upon entrance to school and in grades pre-K or K,1,3,5,7 & 11; (4) scoliosis screening for girls in grades 5 and 7, and boys in grade 9; (5) the confidential maintenance of cumulative health records in accordance with applicable federal and state laws, including the Federal Family Educational Rights and Privacy Act (FERPA); (6) written notification to inform parents or other persons in parental relation to the child, pupils and teachers of the individual child's health condition subject to federal and state confidentiality laws; (7) emergency care of ill or injured students; (8) compliance with immunization requirements; (9) to guide parents, children and teachers in procedures for preventing and correcting defects and diseases; (10) to instruct the school personnel in procedures to take in case of accident or illness; and (11) to survey and make necessary recommendations concerning the health and safety aspects of school facilities and the provision of health information.

When health and welfare services are requested by a religious or independent school, the board of education [in NYC this may include NYC Department of Health and Mental Hygiene (NYCDOHMH)] is obligated to provide services equivalent to those provided to public school students in the district in which the school is located. In the Questions and Answers below, references to provision of health services by the public school district include the provision of those services by the appropriate city department of health.

Questions and Answers

1. Who is required to provide health and welfare services?

The school district within whose geographic boundaries the religious or independent school is located must provide such services. In the city of New York, the agency serving the public schools must provide these services.

2. Is the provision of such services a matter of course?

No. The principal, administrator, teacher, or other person in charge of the religious or independent school must request these services.

3. Is there a particular form, manner, or time for requesting such services?

The law is silent on this point. However, school districts usually plan budgets and staff assignments in the spring for the following school year. Therefore, it is strongly recommended that the religious or independent school principal send a letter of request to the public school superintendent in sufficient time to permit inclusion of such services in the budgetary and work plans. The religious or independent school administrator should confer with the superintendent of the public school district to determine the best time to file such a request.

4. How often must the religious or independent school request such services?

The law does not specify any frequency. However, in general practice the request for such services is a one-time occurrence. It is recommended that such requests be reviewed annually. In so doing, all parties will have an opportunity to discuss the services provided; revise the requests, budgets, and work plans; and renegotiate contracts, if necessary.

5. Must all the health services provided to public school students by a city or county department of health in New York City also be made available to students in religious or independent schools?

Services provided to public school students must be made available to religious or independent school students on an equitable basis.

6. Which health and welfare services must be provided?

All health and welfare services which are provided to students in public schools must be available to students in religious or independent schools, including but not limited to; vision, hearing and scoliosis screening tests, physical examinations, dental screening, in-school immunization, and emergency care for ill or injured students.

7. Are there any limitations on the number or kind of services provided ?

The following services may properly be rendered by school districts to students attending religious or independent schools on school premises: all of the services performed by a physician, dentist, dental hygienist or nurse, including but not limited to; dental prophylaxis; vision, hearing and scoliosis screening tests; recording health histories; physical examinations and in-school immunization; maintaining cumulative health records; and providing health care services for ill or injured students.

However, the school district may not provide any services not currently available to public school students.

8. Must a religious or independent school request all of the health and welfare services provided to public school students?

No. The religious or independent school may request only those services it needs or wants for its students.

9. Who pays for the services to nonresident students?

Section 912 of the Education Law requires a school district to pay for the health services for all school students who reside in their district, even if such students attend a religious or independent school in another district. 

10. How is this arranged?

The school district in which the religious or independent school student resides and the school district providing the services enter into a written contract. The district providing the services determines the appropriate charge, see Information on MOUs for Health Services to Religious and Independent Schools.

11. Are students enrolled in religious and independent schools who are not residents of New York State entitled to these services?

No. No district is required to provide health and welfare services to students who are not residents of New York State.

12. If a religious or independent school has both day and boarding students, must the health and welfare services be provided to both groups?

School health services must be provided to both groups of the students who are New York State residents. However, the school district is not required to provide 24-hour service to the boarding students. Again, no district is required to provide health and welfare services to students who are not residents of New York State.

13. If a religious or independent school does not request health services, must health services be provided?

No.

14. When health services are requested must the school district or city or county department of health also provide equipment and supplies?

The law is silent on this point. In practice, the religious or independent school provides all of the permanent, non-consumable facilities and equipment, e.g., room, furniture, files, scale, telephone and utilities; and the school district provides the consumable supplies, e.g., bandaids, tongue blades, thermometers, student health records and related forms. Equipment such as audiometers and mechanical vision testers are usually provided by the school district for the duration of the testing period.

15. Must the school district provide exactly the same kind of staff and hours of coverage to the religious and independent school students as are provided to the public school students?

No. The law specifies that the services performed and provided by the staff must be the same. The nature of staff coverage may vary and should be based on factors related to student need, student enrollment and time needed to provide the requested services, subject to state and federal laws.

16. Must a school district provide school nursing services in a religious or independent school?

If the district provides nursing services in public schools, these services are to be made available to a religious or independent school on a basis proportional to the number and needs of students in the school. This may mean that a school nurse could spend a few hours a week in a school or be assigned fulltime to a school.

17. How is the equivalency of health and welfare services determined?

Equivalence of services is based upon the nature, scope and quality of the health and welfare services provided for the students in the school district in which the nonpublic school is located. The determination of equivalency of health and welfare services is made by the superintendent of the district which provides the services. Also, a school district may not provide any services not currently available to public school students.

18. Are the services of a speech language pathologist and school psychologist considered to be within the classification of health and welfare services?

Yes.

19. Are there any health services that the religious and independent schools must provide if it does not request health services from the public school district?

Yes. Religious and Independent schools are required to meet the immunization mandates contained in Public Health Law 2164 regardless of whether the school requests health services from the school district.

20. May a religious or independent school ask the public school district to provide only vision screening services and no other health services?

Yes. A religious or independent school may request only those portions of health services that it needs or wants for its students. For example, vision screening of new admissions may be the only request of a religious or independent school.

21. If a public school district provides in-school immunization as a health service for public school students, must this service also be provided for religious and independent school students if requested?

Yes. If the religious or independent school requests this health service, in-school immunization must be provided to its students on the same basis as provided to public school districts.

22. Who is responsible for maintenance, storage and disposition of the cumulative health records provided by the public school district?

Day-to-day maintenance of student health records is the responsibility of the health services staff provided by the school district however, the records of religious and independent school students belong to the religious and independent school and are to be kept in the religious or independent school.  Storage and disposition of the records are the responsibility of the religious and independent school.

23. How long must a religious or independent school retain these records?

While the law does not address this directly, it is recommended that religious and independent schools follow the record retention and disposition schedule  prescribed for public schools. The retention times for two common health records in school are:

• Cumulative student health record: Until student is 27 years old
• Immunization: 6 years, or 3 years after the student attains age 18, whichever is longer
• Information about retention of other records is available from the Office of Religious and Independent School Support.

24. What steps can a religious or independent school take if after requesting in writing school health services the school district of location does not provide the requested health services?

Education Law §310 provides that persons considering themselves aggrieved by an action taken at a school district meeting or by school authorities may appeal to the Commissioner of Education for a review of such action.  In an appeal to the Commissioner pursuant to Education Law §310 seeking reimbursement for health services, an appeal must be commenced within 30 days after the conclusion of the school year in which the costs were incurred See Commissioner’s .  A petitioner may request temporary relief in the form of a stay order when commencing an appeal.  For more information about appeals, see Appeals to the Commissioner | Office of Counsel (nysed.gov).

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