RCW ch. 28A.210 — Revised Code of Washington Chapter 28A.210 RCW — Health—Screening And Requirements

RCW 28A.210.010 Contagious diseases, limiting contact—Rules. The state board of health, after consultation with the superintendent of public instruction, shall adopt reasonable rules regarding the presence of persons on or about any school premises who have, or who have been exposed to, contagious diseases deemed by the state board of health as dangerous to the public health. Such rules shall specify reasonable and precautionary procedures as to such presence and/or readmission of such persons and may include the requirement for a certificate from a licensed physician that there is no danger of contagion. The superintendent of public instruction shall provide to appropriate school officials and personnel, access and notice of these rules of the state board of health. Providing online access to these rules satisfies the requirements of this section. The superintendent of public instruction is required to provide this notice only when there are significant changes to the rules. [ 2009 c 556 s 3; 1971 c 32 s 1; 1969 ex.s. c 223 s 28A.31.010. Prior: 1909 c 97 p 262 s 5; RRS s 4689; prior: 1897 c 118 s 68; 1890 p 372 s 47. Formerly RCW 28A.31.010, 28.31.010.] RCW 28A.210.020 Visual and auditory screening of pupils—Rules. Every board of school directors shall have the power, and it shall be its duty to provide for and require screening for the visual and auditory acuity of all children attending schools in their districts to ascertain which if any of such children have defects sufficient to retard them in their studies. Visual screening shall include both distance and near vision screening. Auditory and visual screening shall be made in accordance with procedures and standards adopted by rule of the state board of health. Prior to the adoption or revision of such rules the state board of health shall seek the recommendations of the superintendent of public instruction regarding the administration of visual and auditory screening and the qualifications of persons competent to administer such screening. Persons performing visual screening may include, but are not limited to, ophthalmologists, optometrists, or opticians who donate their professional services to schools or school districts. If a vision professional who donates his or her services identifies a vision defect sufficient to affect a student's learning, the vision professional must notify the school nurse and/or the school principal in writing and may not contact the student's parents or guardians directly. A school official shall inform parents or guardians of students in writing that a visual examination was recommended, but may not communicate the name or contact information of the vision professional conducting the screening. [ 2016 c 219 s 1; 2009 c 556 s 18; 1971 c 32 s 2; 1969 ex.s. c 223 s 28A.31.030. Prior: 1941 c 202 s 1; Rem. Supp. 1941 s 4689-1. Formerly RCW 28A.31.030, 28.31.030.] RCW 28A.210.030 Visual and auditory screening of pupils—Record of screening—Forwarding of records, recommendations and data. The person or persons completing the screening prescribed in RCW 28A.210.020 shall promptly prepare a record of the screening of each child found to have, or suspected of having, reduced visual and/or auditory acuity in need of attention, including the special education services provided by RCW 28A.155.010 through 28A.155.100, and send copies of such records and recommendations to the parents or guardians of such children and shall deliver the original records to the appropriate school official who shall preserve such records and forward to the superintendent of public instruction and the secretary of health visual and auditory data as requested by such officials. [ 1991 c 3 s 289; 1990 c 33 s 188; 1971 c 32 s 3; 1969 ex.s. c 223 s 28A.31.040. Prior: 1941 c 202 s 2; Rem. Supp. 1941 s 4689-2. Formerly RCW 28A.31.040, 28.31.040.] RCW 28A.210.040 Visual and auditory screening of pupils—Access to rules, records, and forms. The superintendent of public instruction shall provide access to appropriate school officials the rules adopted by the state board of health pursuant to RCW 28A.210.020 and the recommended records and forms to be used in making and reporting such screenings. Providing online access to the materials satisfies the requirements of this section. [ 2009 c 556 s 4; 1990 c 33 s 189; 1973 c 46 s 1. Prior: 1971 c 48 s 12; 1971 c 32 s 4; 1969 ex.s. c 223 s 28A.31.050; prior: 1941 c 202 s 3; RRS s 4689-3. Formerly RCW 28A.31.050, 28.31.050.] NOTES: Severability— RCW 28A.210.045 Speech-language pathology services—Complaints. (1) The superintendent of public instruction shall report to the department of health: (a) Any complaint or disciplinary action taken against a certified educational staff associate providing speech-language pathology services in a school setting; and (b) Any complaint the superintendent receives regarding a speech-language pathology assistant certified under chapter 18.35 RCW. (2) The superintendent of public instruction shall make the reports required by this section as soon as practicable, but in no case later than five business days after the complaint or disciplinary action. [ 2009 c 301 s 13.] NOTES: Intent— RCW 28A.210.060 Immunization program—Purpose. In enacting RCW 28A.210.060 through 28A.210.170, it is the judgment of the legislature that it is necessary to protect the health of the public and individuals by providing a means for the eventual achievement of full immunization of school-age children against certain vaccine-preventable diseases. [ 1990 c 33 s 190; 1984 c 40 s 3; 1979 ex.s. c 118 s 1. Formerly RCW 28A.31.100.] NOTES: Severability— RCW 28A.210.070 Immunization program—Definitions. As used in RCW 28A.210.060 through 28A.210.170: (1) "Chief administrator" shall mean the person with the authority and responsibility for the immediate supervision of the operation of a school or day care center as defined in this section or, in the alternative, such other person as may hereafter be designated in writing for the purposes of RCW 28A.210.060 through 28A.210.170 by the statutory or corporate board of directors of the school district, school, or day care center or, if none, such other persons or person with the authority and responsibility for the general supervision of the operation of the school district, school or day care center. (2) "Child" shall mean any person, regardless of age, in attendance at a public or private school or a licensed day care center. (3) "Day care center" shall mean an agency which regularly provides care for a group of thirteen or more children for periods of less than twenty-four hours and is licensed pursuant to chapter 43.216 RCW. (4) "Full immunization" shall mean immunization against certain vaccine-preventable diseases in accordance with schedules and with immunizing agents approved by the state board of health. (5) "Local health department" shall mean the city, town, county, district or combined city-county health department, board of health, or health officer which provides public health services. (6) "School" shall mean and include each building, facility, and location at or within which any or all portions of a preschool, kindergarten and grades one through twelve program of education and related activities are conducted for two or more children by or in behalf of any public school district and by or in behalf of any private school or private institution subject to approval by the state board of education pursuant to RCW 28A.305.130, 28A.195.010 through 28A.195.050, and 28A.410.120. [ 2017 3rd sp.s. c 6 s 217; 2006 c 263 s 908; 1990 c 33 s 191; 1985 c 49 s 2; 1984 c 40 s 4; 1979 ex.s. c 118 s 2. Formerly RCW 28A.31.102.] NOTES: Reviser's note: RCW 28A.210.080 Immunization program—Attendance of child conditioned upon presentation of alternative proofs—Information regarding meningococcal disease—Information regarding human papillomavirus disease. (1) The attendance of every child at every public and private school in the state and licensed day care center shall be conditioned upon the presentation before or on each child's first day of attendance at a particular school or center, of proof of either (a) full immunization, (b) the initiation of and compliance with a schedule of immunization, as required by rules of the state board of health, or (c) a certificate of exemption as provided for in RCW 28A.210.090. The attendance at the school or the day care center during any subsequent school year of a child who has initiated a schedule of immunization shall be conditioned upon the presentation of proof of compliance with the schedule on the child's first day of attendance during the subsequent school year. Once proof of full immunization or proof of completion of an approved schedule has been presented, no further proof shall be required as a condition to attendance at the particular school or center. (2)(a) Beginning with sixth grade entry, every public and private school in the state shall provide parents and guardians with information about meningococcal disease and its vaccine at the beginning of every school year. The information about meningococcal disease shall include: (i) Its causes and symptoms, how meningococcal disease is spread, and the places where parents and guardians may obtain additional information and vaccinations for their children; and (ii) Current recommendations from the United States centers for disease control and prevention regarding the receipt of vaccines for meningococcal disease and where the vaccination can be received. (b) This subsection shall not be construed to require the department of health or the school to provide meningococcal vaccination to students. (c) The department of health shall prepare the informational materials and shall consult with the office of superintendent of public instruction. (d) This subsection does not create a private right of action. (3)(a) Beginning with sixth grade entry, every public school in the state shall provide parents and guardians with information about human papillomavirus disease and its vaccine at the beginning of every school year. The information about human papillomavirus disease shall include: (i) Its causes and symptoms, how human papillomavirus disease is spread, and the places where parents and guardians may obtain additional information and vaccinations for their children; and (ii) Current recommendations from the United States centers for disease control and prevention regarding the receipt of vaccines for human papillomavirus disease and where the vaccination can be received. (b) This subsection shall not be construed to require the department of health or the school to provide human papillomavirus vaccination to students. (c) The department of health shall prepare the informational materials and shall consult with the office of the superintendent of public instruction. (d) This subsection does not create a private right of action. (4) Private schools are required by state law to notify parents that information on the human papillomavirus disease prepared by the department of health is available. [ 2007 c 276 s 1; 2005 c 404 s 1; 1990 c 33 s 192; 1985 c 49 s 1; 1979 ex.s. c 118 s 3. Formerly RCW 28A.31.104.] NOTES: Effective date— RCW 28A.210.090 Immunization program—Exemptions. (Effective until June 30, 2027.) (1) Any child shall be exempt in whole or in part from the immunization measures required by RCW 28A.210.060 through 28A.210.170 upon the presentation of any one or more of the certifications required by this section, on a form prescribed by the department of health: (a) A written certification signed by a health care practitioner that a particular vaccine required by rule of the state board of health is, in his or her judgment, not advisable for the child: PROVIDED, That when it is determined that this particular vaccine is no longer contraindicated, the child will be required to have the vaccine; (b) A written certification signed by any parent or legal guardian of the child or any adult in loco parentis to the child that the religious beliefs of the signator are contrary to the required immunization measures; or (c) A written certification signed by any parent or legal guardian of the child or any adult in loco parentis to the child that the signator has either a philosophical or personal objection to the immunization of the child. A philosophical or personal objection may not be used to exempt a child from the measles, mumps, and rubella vaccine. (2)(a) The form presented on or after July 22, 2011, must include a statement to be signed by a health care practitioner stating that he or she provided the signator with information about the benefits and risks of immunization to the child. The form may be signed by a health care practitioner at any time prior to the enrollment of the child in a school or licensed day care. Photocopies of the signed form or a letter from the health care practitioner referencing the child's name shall be accepted in lieu of the original form. (b) A health care practitioner who, in good faith, signs the statement provided for in (a) of this subsection is immune from civil liability for providing the signature. (c) Any parent or legal guardian of the child or any adult in loco parentis to the child who exempts the child due to religious beliefs pursuant to subsection (1)(b) of this section is not required to have the form provided for in (a) of this subsection signed by a health care practitioner if the parent or legal guardian demonstrates membership in a religious body or a church in which the religious beliefs or teachings of the church preclude a health care practitioner from providing medical treatment to the child. (3) For purposes of this section, "health care practitioner" means a physician licensed under chapter 18.71 or 18.57 RCW, a naturopath licensed under chapter 18.36A RCW, a physician assistant licensed under chapter 18.71A RCW, or an *advanced registered nurse practitioner licensed under chapter 18.79 RCW. [ 2020 c 80 s 27; 2019 c 362 s 2; 2011 c 299 s 1; 1991 c 3 s 290; 1990 c 33 s 193; 1984 c 40 s 5; 1979 ex.s. c 118 s 4. Formerly RCW 28A.31.106.] NOTES: *Reviser's note: RCW 28A.210.100 Immunization program—Source of immunizations—Written records. The immunizations required by RCW 28A.210.060 through 28A.210.170 may be obtained from any private or public source desired: PROVIDED, That the immunization is administered and records are made in accordance with the regulations of the state board of health. Any person or organization administering immunizations shall furnish each person immunized, or his or her parent or legal guardian, or any adult in loco parentis to the child, with a written record of immunization given in a form prescribed by the state board of health. [ 1990 c 33 s 194; 1984 c 40 s 7; 1979 ex.s. c 118 s 6. Formerly RCW 28A.31.110.] NOTES: Severability— RCW 28A.210.110 Immunization program—Administrator's duties upon receipt of proof of immunization or certification of exemption. A child's proof of immunization or certification of exemption shall be presented to the chief administrator of the public or private school or day care center or to his or her designee for that purpose. The chief administrator shall: (1) Retain such records pertaining to each child at the school or day care center for at least the period the child is enrolled in the school or attends such center; (2) Retain a record at the school or day care center of the name, address, and date of exclusion of each child excluded from school or the center pursuant to RCW 28A.210.120 for not less than three years following the date of a child's exclusion; (3) File a written annual report with the department of health on the immunization status of students or children attending the day care center at a time and on forms prescribed by the department of health; and (4) Allow agents of state and local health departments access to the records retained in accordance with this section during business hours for the purposes of inspection and copying. [ 1991 c 3 s 291; 1990 c 33 s 195; 1979 ex.s. c 118 s 7. Formerly RCW 28A.31.112.] NOTES: Effective date— RCW 28A.210.120 Immunization program—Prohibiting child's presence—Notice to parent, guardian, or adult in loco parentis. It shall be the duty of the chief administrator of every public and private school and day care center to prohibit the further presence at the school or day care center for any and all purposes of each child for whom proof of immunization, certification of exemption, or proof of compliance with an approved schedule of immunization has not been provided in accordance with RCW 28A.210.080 and to continue to prohibit the child's presence until such proof of immunization, certification of exemption, or approved schedule has been provided. The exclusion of a child from a school shall be accomplished in accordance with rules of the office of the superintendent, in consultation with the state board of health. The exclusion of a child from a day care center shall be accomplished in accordance with rules of the department of social and health services. Prior to the exclusion of a child, each school or day care center shall provide written notice to the parent(s) or legal guardian(s) of each child or to the adult(s) in loco parentis to each child, who is not in compliance with the requirements of RCW 28A.210.080. The notice shall fully inform such person(s) of the following: (1) The requirements established by and pursuant to RCW 28A.210.060 through 28A.210.170; (2) the fact that the child will be prohibited from further attendance at the school unless RCW 28A.210.080 is complied with; (3) such procedural due process rights as are hereafter established pursuant to RCW 28A.210.160 and/or 28A.210.170, as appropriate; and (4) the immunization services that are available from or through the local health department and other public agencies. [ 2006 c 263 s 909; 1990 c 33 s 196; 1985 c 49 s 3; 1984 c 40 s 8; 1979 ex.s. c 118 s 8. Formerly RCW 28A.31.114.] NOTES: Findings— RCW 28A.210.130 Immunization program—Superintendent of public instruction to provide information. The superintendent of public instruction shall provide for information about the immunization program and requirements under RCW 28A.210.060 through 28A.210.170 to be widely available throughout the state in order to promote full use of the program. [ 1990 c 33 s 197; 1985 c 49 s 4. Formerly RCW 28A.31.115.] RCW 28A.210.140 Immunization program—State board of health rules, contents. The state board of health shall adopt and is hereby empowered to adopt rules pursuant to chapter 34.05 RCW which establish the procedural and substantive requirements for full immunization and the form and substance of the proof thereof, to be required pursuant to RCW 28A.210.060 through 28A.210.170. [ 1990 c 33 s 198; 1984 c 40 s 9; 1979 ex.s. c 118 s 9. Formerly RCW 28A.31.116.] NOTES: Severability— RCW 28A.210.150 Immunization program—Superintendent of public instruction by rule to adopt procedures for verifying records. The superintendent of public instruction by rule shall provide procedures for schools to quickly verify the immunization records of students transferring from one school to another before the immunization records are received. [ 1985 c 49 s 5. Formerly RCW 28A.31.117.] RCW 28A.210.160 Immunization program—Rules. The superintendent of public instruction with regard to public schools and the state board of education with regard to private schools, in consultation with the state board of health, shall each adopt rules pursuant to chapter 34.05 RCW that establish the procedural and substantive due process requirements governing the exclusion of children from schools pursuant to RCW 28A.210.120. [ 2006 c 263 s 910; 1990 c 33 s 199; 1979 ex.s. c 118 s 10. Formerly RCW 28A.31.118.] NOTES: Findings— RCW 28A.210.170 Immunization program—Department of social and health services' rules, contents. The department of social and health services shall and is hereby empowered to adopt rules pursuant to chapter 34.05 RCW which establish the procedural and substantive due process requirements governing the exclusion of children from day care centers pursuant to RCW 28A.210.120. [ 1990 c 33 s 200; 1979 ex.s. c 118 s 11. Formerly RCW 28A.31.120.] NOTES: Effective date— RCW 28A.210.255 Provision of health services in public and private schools—Employee job description. Any employee of a public school district or private school that performs health services, such as catheterization, must have a job description that lists all of the health services that the employee may be required to perform for students. [ 2003 c 172 s 2.] RCW 28A.210.260 Public and private schools—Administration of medication—Conditions. (1) Public school districts and private schools which conduct any of grades kindergarten through the twelfth grade may provide for the administration of oral medication, topical medication, eye drops, ear drops, or nasal spray, of any nature to students who are in the custody of the school district or school at the time of administration, but are not required to do so by this section, subject to the following conditions: (a) The board of directors of the public school district or the governing board of the private school or, if none, the chief administrator of the private school shall adopt policies which address the designation of employees who may administer oral medications, topical medications, eye drops, ear drops, or nasal spray to students, the acquisition of parent requests and instructions, and the acquisition of requests from licensed health professionals prescribing within the scope of their prescriptive authority and instructions regarding students who require medication for more than fifteen consecutive school days, the identification of the medication to be administered, the means of safekeeping medications with special attention given to the safeguarding of legend drugs as defined in chapter 69.41 RCW, and the means of maintaining a record of the administration of such medication. Policies adopted in accordance with this subsection (1) may not permit a school nurse to delegate the responsibility to administer student medications to a parent-designated adult who is not a school employee; (b) The board of directors shall seek advice from one or more licensed physicians or nurses in the course of developing the foregoing policies; (c) The public school district or private school is in receipt of a written, current and unexpired request from a parent, or a legal guardian, or other person having legal control over the student to administer the medication to the student; (d) The public school district or the private school is in receipt of: (i) A written, current and unexpired request from a licensed health professional prescribing within the scope of his or her prescriptive authority for administration of the medication, as there exists a valid health reason which makes administration of such medication advisable during the hours when school is in session or the hours in which the student is under the supervision of school officials; and (ii) written, current and unexpired instructions from such licensed health professional prescribing within the scope of his or her prescriptive authority regarding the administration of prescribed medication to students who require medication for more than fifteen consecutive workdays; (e) The medication is administered by an employee designated by or pursuant to the policies adopted pursuant to (a) of this subsection and in substantial compliance with the prescription of a licensed health professional prescribing within the scope of his or her prescriptive authority or the written instructions provided pursuant to (d) of this subsection; (f) The medication is first examined by the employee administering the same to determine in his or her judgment that it appears to be in the original container and to be properly labeled; (g) The board of directors shall designate a professional person licensed pursuant to chapter 18.71 or 18.79 RCW as it applies to registered nurses and *advanced registered nurse practitioners, to delegate to, train, and supervise the designated school district personnel in proper medication procedures; and (h) To be eligible to be a parent-designated adult, a school district employee not licensed under chapter 18.79 RCW must file, without coercion by the employer, a voluntary written, current, and unexpired letter of intent stating the employee's willingness to be a parent-designated adult. If a school district employee who is not licensed under chapter 18.79 RCW chooses not to file a letter under this section, the employee may not be subject to any employer reprisal or disciplinary action for refusing to file a letter. A parent-designated adult must be a volunteer, who may be a school district employee. The professional person designated under this subsection is not responsible for the supervision of the parent-designated adult for those procedures that are authorized by the parents. (2) This section does not apply to: (a) Topical sunscreen products regulated by the United States food and drug administration for over-the-counter use. Provisions related to possession and application of topical sunscreen products are in RCW 28A.210.278; and (b) Opioid overdose reversal medication. Provisions related to maintenance and administration of opioid overdose reversal medication are in RCW 28A.210.390. [ 2021 c 29 s 2; 2019 c 314 s 41; 2017 c 186 s 2; 2013 c 180 s 1; 2012 c 16 s 1; 2000 c 63 s 1; 1994 sp.s. c 9 s 720; 1982 c 195 s 1. Formerly RCW 28A.31.150.] NOTES: *Reviser's note: RCW 28A.210.270 Public and private schools—Administration of medication—Immunity from liability—Discontinuance, procedure. (1) In the event a school employee administers oral medication, topical medication, eye drops, ear drops, or nasal spray to a student pursuant to RCW 28A.210.260 in substantial compliance with the prescription of the student's licensed health professional prescribing within the scope of the professional's prescriptive authority or the written instructions provided pursuant to RCW 28A.210.260(1)(d), and the other conditions set forth in RCW 28A.210.260 have been substantially complied with, then the employee, the employee's school district or school of employment, and the members of the governing board and chief administrator thereof shall not be liable in any criminal action or for civil damages in their individual or marital or governmental or corporate or other capacities as a result of the administration of the medication. (2) The administration of oral medication, topical medication, eye drops, ear drops, or nasal spray to any student pursuant to RCW 28A.210.260 may be discontinued by a public school district or private school and the school district or school, its employees, its chief administrator, and members of its governing board shall not be liable in any criminal action or for civil damages in their governmental or corporate or individual or marital or other capacities as a result of the discontinuance of such administration: PROVIDED, That the chief administrator of the public school district or private school, or his or her designee, has first provided actual notice orally or in writing in advance of the date of discontinuance to a parent or legal guardian of the student or other person having legal control over the student. [ 2019 c 314 s 42; 2013 c 180 s 2; 2012 c 16 s 2; 2000 c 63 s 2; 1990 c 33 s 208; 1982 c 195 s 2. Formerly RCW 28A.31.155.] NOTES: Declaration— RCW 28A.210.275 Administration of medications by employees not licensed under chapter 18.79 RCW—Requirements—Immunity from liability. (Effective until June 30, 2027.) (1) Beginning July 1, 2014, a school district employee not licensed under chapter 18.79 RCW who is asked to administer medications or perform nursing services not previously recognized in law shall at the time he or she is asked to administer the medication or perform the nursing service file, without coercion by the employer, a voluntary written, current, and unexpired letter of intent stating the employee's willingness to administer the new medication or nursing service. It is understood that the letter of intent will expire if the conditions of acceptance are substantially changed. If a school employee who is not licensed under chapter 18.79 RCW chooses not to file a letter under this section, the employee is not subject to any employer reprisal or disciplinary action for refusing to file a letter. (2) In the event a school employee provides the medication or service to a student in substantial compliance with (a) rules adopted by the state board of nursing and the instructions of a registered nurse or *advanced registered nurse practitioner issued under such rules, and (b) written policies of the school district, then the employee, the employee's school district or school of employment, and the members of the governing board and chief administrator thereof are not liable in any criminal action or for civil damages in his or her individual, marital, governmental, corporate, or other capacity as a result of providing the medication or service. (3) The board of directors shall designate a professional person licensed under chapter 18.71, 18.57, or 18.79 RCW as it applies to registered nurses and *advanced registered nurse practitioners to consult and coordinate with the student's parents and health care provider, and train and supervise the appropriate school district personnel in proper procedures to ensure a safe, therapeutic learning environment. School employees must receive the training provided under this subsection before they are authorized to deliver the service or medication. Such training must be provided, where necessary, on an ongoing basis to ensure that the proper procedures are not forgotten because the services or medication are delivered infrequently. [ 2025 c 58 s 5043; 2014 c 204 s 2.] NOTES: * RCW 28A.210.278 Topical sunscreen products—Sun safety guidelines. (1) Any person, including students, parents, and school personnel, may possess topical sunscreen products to help prevent sunburn while on school property, at a school-related event or activity, or at summer camp. As excepted in RCW 28A.210.260, a sunscreen product may be possessed and applied under this section without the prescription or note of a licensed health care professional if the product is regulated by the United States food and drug administration for over-the-counter use. For student use, a sunscreen product must be supplied by a parent or guardian. (2) Schools are encouraged to educate students about sun safety guidelines. (3) Nothing in this section requires school personnel to assist students in applying sunscreen. (4) As used in this section, "school" means a public school, school district, educational service district, or private school with any of grades kindergarten through twelve. [ 2017 c 186 s 1.] NOTES: Application— RCW 28A.210.280 Catheterization of public and private school students. (Effective until June 30, 2027.) (1) Public school districts and private schools that offer classes for any of grades kindergarten through twelve must provide for clean, intermittent bladder catheterization of students, or assisted self-catheterization of students pursuant to RCW 18.79.290. The catheterization must be provided in substantial compliance with: (a) Rules adopted by the state board of nursing and the instructions of a registered nurse or *advanced registered nurse practitioner issued under such rules; and (b) Written policies of the school district or private school which shall be adopted in order to implement this section and shall be developed in accordance with such requirements of chapters 41.56 and 41.59 RCW as may be applicable. (2) School district employees, except those licensed under chapter 18.79 RCW, who have not agreed in writing to perform clean, intermittent bladder catheterization as a specific part of their job description, may file a written letter of refusal to perform clean, intermittent bladder catheterization of students. This written letter of refusal may not serve as grounds for discharge, nonrenewal, or other action adversely affecting the employee's contract status. (3) Any public school district or private school that provides clean, intermittent bladder catheterization shall document the provision of training given to employees who perform these services. These records shall be made available for review at any audit. [ 2025 c 58 s 5044; 2003 c 172 s 1; 1994 sp.s. c 9 s 721; 1988 c 48 s 2. Formerly RCW 28A.31.160.] NOTES: * RCW 28A.210.290 Catheterization of public and private school students—Immunity from liability. (Effective until June 30, 2027.) (1) In the event a school employee provides for the catheterization of a student pursuant to RCW 18.79.290 and 28A.210.280 in substantial compliance with (a) rules adopted by the state board of nursing and the instructions of a registered nurse or *advanced registered nurse practitioner issued under such rules, and (b) written policies of the school district or private school, then the employee, the employee's school district or school of employment, and the members of the governing board and chief administrator thereof shall not be liable in any criminal action or for civil damages in their individual, marital, governmental, corporate, or other capacity as a result of providing for the catheterization. (2) Providing for the catheterization of any student pursuant to RCW 18.79.290 and 28A.210.280 may be discontinued by a public school district or private school and the school district or school, its employees, its chief administrator, and members of its governing board shall not be liable in any criminal action or for civil damages in their individual, marital, governmental, corporate, or other capacity as a result of the discontinuance: PROVIDED, That the chief administrator of the public school district or private school, or his or her designee, has first provided actual notice orally or in writing in advance of the date of discontinuance to a parent or legal guardian of the student or other person having legal control over the student: PROVIDED FURTHER, That the public school district otherwise provides for the catheterization of the student to the extent required by federal or state law. [ 2025 c 58 s 5045; 1994 sp.s. c 9 s 722; 1990 c 33 s 209; 1988 c 48 s 3. Formerly RCW 28A.31.165.] NOTES: * RCW 28A.210.300 School physician or school nurse may be employed. The board of directors of any school district of the second class may employ a regularly licensed physician or a licensed public health nurse for the purpose of protecting the health of the children in said district. [ 1975 c 43 s 20; 1969 ex.s. c 223 s 28A.60.320. Prior: 1937 c 60 s 1; RRS s 4776-4. Formerly RCW 28A.60.320, 28.31.080.] NOTES: Effective date— RCW 28A.210.305 Registered nurse or advanced registered nurse practitioner—Duties relating to nursing care of students—Notice to school districts. (Effective until June 30, 2027.) (1)(a) A registered nurse or an *advanced registered nurse practitioner licensed under chapter 18.79 RCW working in a school setting is authorized and responsible for the nursing care of students to the extent that the care is within the practice of nursing as defined in this section. (b) A school administrator may supervise a registered nurse or an *advanced registered nurse practitioner licensed under chapter 18.79 RCW in aspects of employment other than the practice of nursing as defined in this section. (c) Only a registered nurse or an *advanced registered nurse practitioner licensed under chapter 18.79 RCW may supervise, direct, or evaluate a licensed nurse working in a school setting with respect to the practice of nursing as defined in this section. (2) Nothing in this section: (a) Prohibits a nonnurse supervisor from supervising, directing, or evaluating a licensed nurse working in a school setting with respect to matters other than the practice of nursing; (b) Requires a registered nurse or an *advanced registered nurse practitioner to be clinically supervised in a school setting; or (c) Prohibits a nonnurse supervisor from conferring with a licensed nurse working in a school setting with respect to the practice of nursing. (3) Within existing funds, the superintendent of public instruction shall notify each school district in this state of the requirements of this section. (4) For purposes of this section, "practice of nursing" means: (a) Registered nursing practice as defined in RCW 18.79.040, **advanced registered nursing practice as defined in RCW 18.79.050, and licensed practical nursing practice as defined in RCW 18.79.060, including, but not limited to: (i) The administration of medication pursuant to a medication or treatment order; and (ii) The decision to summon emergency medical assistance; and (b) Compliance with any state or federal statute or administrative rule specifically regulating licensed nurses, including any statute or rule defining or establishing standards of patient care or professional conduct or practice. [ 2017 c 84 s 2.] NOTES: Reviser's note: RCW 28A.210.310 Prohibition on use of tobacco products on school property. (1) To protect children in the public schools of this state from exposure to the addictive substance of nicotine, each school district board of directors shall have a written policy mandating a prohibition on the use of all tobacco products on public school property. (2) The policy in subsection (1) of this section shall include, but not be limited to, a requirement that students and school personnel be notified of the prohibition, the posting of signs prohibiting the use of tobacco products, sanctions for students and school personnel who violate the policy, and a requirement that school district personnel enforce the prohibition. Enforcement policies adopted in the school board policy shall be in addition to the enforcement provisions in RCW 70.160.070. [ 1997 c 9 s 1; 1989 c 233 s 6. Formerly RCW 28A.31.170.] NOTES: Effective date— RCW 28A.210.320 Children with life-threatening health conditions—Medication or treatment orders—Rules. (1) The attendance of every child at every public school in the state shall be conditioned upon the presentation before or on each child's first day of attendance at a particular school of a medication or treatment order addressing any life-threatening health condition that the child has that may require medical services to be performed at the school. Once such an order has been presented, the child shall be allowed to attend school. (2) The chief administrator of every public school shall prohibit the further presence at the school for any and all purposes of each child for whom a medication or treatment order has not been provided in accordance with this section if the child has a life-threatening health condition that may require medical services to be performed at the school and shall continue to prohibit the child's presence until such order has been provided. The exclusion of a child from a school shall be accomplished in accordance with rules of the state board of education. Before excluding a child, each school shall provide written notice to the parents or legal guardians of each child or to the adults in loco parentis to each child, who is not in compliance with the requirements of this section. The notice shall include, but not be limited to, the following: (a) The requirements established by this section; (b) the fact that the child will be prohibited from further attendance at the school unless this section is complied with; and (c) such procedural due process rights as are established pursuant to this section. (3) The superintendent of public instruction in consultation with the state board of health shall adopt rules under chapter 34.05 RCW that establish the procedural and substantive due process requirements governing the exclusion of children from public schools under this section. The rules shall include any requirements under applicable federal laws. (4) As used in this section, "life-threatening condition" means a health condition that will put the child in danger of death during the school day if a medication or treatment order and a nursing plan are not in place. (5) As used in this section, "medication or treatment order" means the authority a registered nurse obtains under RCW 18.79.260(2). [ 2006 c 263 s 911; 2002 c 101 s 1.] NOTES: Findings— RCW 28A.210.325 Medical use of cannabis-infused products—Administration by parent or guardian—School districts to develop policies. (1) A school district must permit a student who meets the requirements of RCW 69.51A.220 to consume cannabis-infused products for medical purposes on school grounds, aboard a school bus, or while attending a school-sponsored event in accordance with the school district's policy adopted under this section. (2) Upon the request of a parent or guardian of a student who meets the requirements of RCW 69.51A.220, the board of directors of a school district shall adopt a policy to authorize parents or guardians to administer cannabis-infused products to a student for medical purposes while the student is on school grounds, aboard a school bus, or attending a school-sponsored event. The policy must, at a minimum: (a) Require that the student be authorized to use cannabis-infused products for medical purposes pursuant to RCW 69.51A.220 and that the parent or guardian acts as the designated provider for the student and assists the student with the consumption of the cannabis while on school grounds, aboard a school bus, or attending a school-sponsored event; (b) Establish protocols for verifying the student is authorized to use cannabis for medical purposes and the parent or guardian is acting as the designated provider for the student pursuant to RCW 69.51A.220. The school may consider a student's and parent's or guardian's valid recognition cards to be proof of compliance with RCW 69.51A.220; (c) Expressly authorize parents or guardians of students who have been authorized to use cannabis for medical purposes to administer cannabis-infused products to the student while the student is on school grounds at a location identified pursuant to (d) of this subsection (2), aboard a school bus, or attending a school-sponsored event; (d) Identify locations on school grounds where cannabis-infused products may be administered; and (e) Prohibit the administration of medical cannabis to a student by smoking or other methods involving inhalation while the student is on school grounds, aboard a school bus, or attending a school-sponsored event. (3) School district officials, employees, volunteers, students, and parents and guardians acting in accordance with the school district policy adopted under subsection (2) of this section may not be arrested, prosecuted, or subject to other criminal sanctions, or civil or professional consequences for possession, manufacture, or delivery of, or for possession with intent to manufacture or deliver cannabis under state law, or have real or personal property seized or forfeited for possession, manufacture, or delivery of, or possession with intent to manufacture or deliver cannabis under state law. (4) For the purposes of this section, "cannabis-infused products" has the meaning provided in RCW 69.50.101. [ 2022 c 16 s 25; 2019 c 204 s 1.] NOTES: Intent— RCW 28A.210.330 Students with diabetes—Individual health plans—Designation of professional to consult and coordinate with parents and health care provider—Training and supervision of school district personnel. (1) School districts shall provide individual health plans for students with diabetes, subject to the following conditions: (a) The board of directors of the school district shall adopt policies to be followed for students with diabetes. The policies shall include, but need not be limited to: (i) The acquisition of parent requests and instructions; (ii) The acquisition of orders from licensed health professionals prescribing within the scope of their prescriptive authority for monitoring and treatment at school; (iii) The provision for storage of medical equipment and medication provided by the parent; (iv) The provision for students to perform blood glucose tests, administer insulin, treat hypoglycemia and hyperglycemia, and have easy access to necessary supplies and equipment to perform monitoring and treatment functions as specified in the individual health plan. The policies shall include the option for students to carry on their persons the necessary supplies and equipment and the option to perform monitoring and treatment functions anywhere on school grounds including the students' classrooms, and at school-sponsored events; (v) The establishment of school policy exceptions necessary to accommodate the students' needs to eat whenever and wherever necessary, have easy, unrestricted access to water and bathroom use, have provisions made for parties at school when food is served, eat meals and snacks on time, and other necessary exceptions as described in the individual health plan; (vi) The assurance that school meals are never withheld because of nonpayment of fees or disciplinary action; (vii) A description of the students' school day schedules for timing of meals, snacks, blood sugar testing, insulin injections, and related activities; (viii) The development of individual emergency plans; (ix) The distribution of the individual health plan to appropriate staff based on the students' needs and staff level of contact with the students; (x) The possession of legal documents for parent-designated adults to provide care, if needed; and (xi) The updating of the individual health plan at least annually or more frequently, as needed; and (b) The board of directors, in the course of developing the policies in (a) of this subsection, shall seek advice from one or more licensed physicians or nurses or diabetes educators who are nationally certified. (2)(a) For the purposes of this section, "parent-designated adult" means a volunteer, who may be a school district employee, who receives additional training from a health care professional or expert in diabetic care selected by the parents, and who provides care for the child consistent with the individual health plan. (b) To be eligible to be a parent-designated adult, a school district employee not licensed under chapter 18.79 RCW shall file, without coercion by the employer, a voluntary written, current, and unexpired letter of intent stating the employee's willingness to be a parent-designated adult. If a school employee who is not licensed under chapter 18.79 RCW chooses not to file a letter under this section, the employee shall not be subject to any employer reprisal or disciplinary action for refusing to file a letter. (3) The board of directors shall designate a professional person licensed under chapter 18.71, 18.57, or 18.79 RCW as it applies to registered nurses and *advanced registered nurse practitioners, to consult and coordinate with the student's parents and health care provider, and train and supervise the appropriate school district personnel in proper procedures for care for students with diabetes to ensure a safe, therapeutic learning environment. Training may also be provided by a diabetes educator who is nationally certified. Parent-designated adults who are school employees are required to receive the training provided under this subsection. Parent-designated adults who are not school employees shall show evidence of comparable training. The parent-designated adult must also receive additional training as established in subsection (2)(a) of this section for the additional care the parents have authorized the parent-designated adult to provide. The professional person designated under this subsection is not responsible for the supervision of the parent-designated adult for those procedures that are authorized by the parents. [ 2002 c 350 s 2.] NOTES: *Reviser's note: RCW 28A.210.340 Students with diabetes—Adoption of policy for inservice training for school staff. The superintendent of public instruction and the secretary of the department of health shall develop a uniform policy for all school districts providing for the inservice training for school staff on symptoms, treatment, and monitoring of students with diabetes and on the additional observations that may be needed in different situations that may arise during the school day and during school-sponsored events. The policy shall include the standards and skills that must be in place for inservice training of school staff. [ 2002 c 350 s 3.] NOTES: Findings— RCW 28A.210.350 Students with diabetes, epilepsy or other seizure disorders, or adrenal insufficiency—Compliance with individual health plan—Immunity. A school district, school district employee, agent, or parent-designated adult who, acting in good faith and in substantial compliance with the student's individual health plan and the instructions of the student's licensed health care professional, provides assistance or services under RCW 28A.210.330, 28A.210.355, or 28A.210.358 shall not be liable in any criminal action or for civil damages in his or her individual or marital or governmental or corporate or other capacities as a result of the services provided under RCW 28A.210.330 to students with diabetes, under RCW 28A.210.355 to students with epilepsy or other seizure disorders, or under RCW 28A.210.358 to students with adrenal insufficiency. [ 2025 c 356 s 3; 2021 c 29 s 3; 2002 c 350 s 4.] NOTES: Findings— RCW 28A.210.355 Students with epilepsy or other seizure disorders—Individual health plans—Designation of professional to consult and coordinate with parents and health care provider—Training and supervision of school district personnel—Parent-designated adults. (1) School districts shall provide individual health plans for students with epilepsy or other seizure disorders, subject to the following conditions: (a) The board of directors of the school district shall adopt and periodically revise policies to be followed for students with epilepsy or other seizure disorders. The policies must cover, but need not be limited to, the following subjects: (i) The acquisition of parent requests and instructions; (ii) The acquisition of orders from licensed health professionals prescribing within the scope of their prescriptive authority for monitoring and treatment of seizure disorders at school; (iii) The provision for storage of medical equipment and medication provided by the parent; (iv) The establishment of school policy exceptions necessary to accommodate the students' needs related to epilepsy or other seizure disorders as described in the individual health plan; (v) The development of individual emergency plans; (vi) The distribution of the individual health plan to appropriate staff based on the students' needs and staff level of contact with the student; (vii) The possession of legal documents for parent-designated adults to provide care, if needed; and (viii) The updating of the individual health plan at least annually; and (b) The board of directors, in the course of developing the policies in (a) of this subsection, shall consult with one or more licensed physicians or nurses, or appropriate personnel from a national epilepsy organization that offers seizure training and education for school nurses and other school personnel. (2)(a) The board of directors shall designate a professional person licensed under chapter 18.71, 18.57, or 18.79 RCW as it applies to registered nurses and *advanced registered nurse practitioners, to consult and coordinate with the student's parents and health care provider, and train and supervise the appropriate school district personnel in proper procedures for care for students with epilepsy or other seizure disorders to ensure a safe, therapeutic learning environment. Training required under this subsection (2)(a) may also be provided by a national organization that offers training for school nurses for managing students with seizures and seizure training for school personnel. (b)(i) Parent-designated adults who are school district employees must receive training in accordance with (a) of this subsection (2). (ii) Parent-designated adults who are not school district employees must show evidence of training in proper procedures for care of students with epilepsy or other seizure disorders. Training required under this subsection (2)(b)(ii) may be provided by a national organization that offers training for school nurses for managing students with seizures and seizure training for school personnel. (iii) The professional person designated under (a) of this subsection (2) is not responsible for the supervision of the parent-designated adult for procedures authorized by the parents. (3)(a) To be eligible to be a parent-designated adult, a school district employee not licensed under chapter 18.79 RCW shall file, without coercion by the employer, a voluntary written, current, and unexpired letter of intent stating the employee's willingness to be a parent-designated adult. If a school district employee who is not licensed under chapter 18.79 RCW chooses not to file a letter under this section, the employee may not be subject to any employer reprisal or disciplinary action for refusing to file a letter. (b)(i) For the purposes of this section, "parent-designated adult" means a parent-designated adult who: (A) Volunteers for the designation; (B) receives additional training from a health care professional or expert in care for epilepsy or other seizure disorders selected by the parents; and (C) provides care for the child consistent with the individual health plan. (ii) A parent-designated adult may be a school district employee. (4) Nothing in this section is intended to supersede or otherwise modify nurse delegation requirements established in RCW 18.79.260. (5) This section applies beginning with the 2022-23 school year. [ 2021 c 29 s 1.] NOTES: *Reviser's note: RCW 28A.210.358 Students with adrenal insufficiency—Individual health plans—Parent-designated adult. (1) School districts shall provide individual health plans for students with adrenal insufficiency, subject to the following conditions: (a) The board of directors of the school district shall adopt and periodically revise policies governing the care of students with adrenal insufficiency. At a minimum, the policies must address: (i) The acquisition of parent requests and instructions; (ii) The acquisition of orders from licensed health professionals prescribing within the scope of their prescriptive authority for monitoring and treatment of adrenal insufficiency at school; (iii) The provision for storage of medical equipment and medication provided by the parent; (iv) The establishment of necessary exceptions to school policies to accommodate the specific needs of students with adrenal insufficiency, as described in the students' individual health plan; (v) The development of emergency care plans; (vi) The distribution of individual health plans and emergency care plans to appropriate staff based on the students' needs and staff level of contact with the student; (vii) The possession of legal documents for parent-designated adults to provide care, if needed; and (viii) The updating of the individual health plan at least annually; (b) The administration of medications under the policies required in (a) of this subsection (1) must also comply with conditions outlined in RCW 28A.210.260; and (c) The policies required by (a) of this subsection (1) may be incorporated into school district policies related broadly to students with health conditions or those concerning parent-designated adults. (2)(a) Parents of a child with adrenal insufficiency who assign a parent-designated adult to care for the child shall authorize the parent-designated adult to perform procedures consistent with the child's individual health plan. (b) Parent-designated adults must complete training selected by the child's parents in the proper procedures to care for the child, including in the administration of an emergency injection of corticosteroid during an adrenal crisis, that are consistent with the child's individual health plan. The training may be provided by an organization that offers training for staff caring for students with adrenal insufficiency or an organization that offers training for caretakers of children with adrenal insufficiency. (c) To be eligible to be a parent-designated adult for a child with adrenal insufficiency, a school district employee not licensed under chapter 18.79 RCW shall file, without coercion by the employer, a voluntary written, current, and unexpired letter of intent stating the employee's willingness to be a parent-designated adult. If a school district employee who is not licensed under chapter 18.79 RCW chooses not to file a letter under this section, the employee may not be subject to any employer reprisal or disciplinary action for refusing to file a letter. (3)(a) For the purposes of this section, "parent-designated adult" means an adult who: (i) Is authorized by the parents of a child with adrenal insufficiency to provide care for the child consistent with the child's individual health plan; (ii) volunteers for the designation; (iii) receives additional training selected by the parents; and (iv) provides care for the child consistent with the child's individual health plan. (b) A parent-designated adult may be a school district employee. (4) Nothing in this section is intended to supersede or otherwise modify nurse delegation requirements established in RCW 18.79.260. (5) This section applies beginning with the 2025-26 school year. [ 2025 c 356 s 2.] NOTES: Findings— RCW 28A.210.360 Model policy on access to nutritious foods and developmentally appropriate exercise—School district policies. (1) Consistent with the essential academic learning requirements for health and fitness, including nutrition, the Washington state school directors' association, with the assistance of the office of the superintendent of public instruction, the department of health, and the Washington alliance for health, physical education, recreation and dance, shall convene an advisory committee to develop a model policy regarding access to nutritious foods, opportunities for developmentally appropriate exercise, and accurate information related to these topics. The policy shall address the nutritional content of foods and beverages, including fluoridated bottled water, sold or provided throughout the school day or sold in competition with the federal school breakfast and lunch program and the availability and quality of health, nutrition, and physical education and fitness curriculum. The model policy should include the development of a physical education and fitness curriculum for students. For middle school students, physical education and fitness curriculum means a daily period of physical activity, a minimum of twenty minutes of which is aerobic activity in the student's target heart rate zone, which includes instruction and practice in basic movement and fine motor skills, progressive physical fitness, athletic conditioning, and nutrition and wellness instruction through age-appropriate activities. (2) The school directors' association shall submit the model policy and recommendations on the related issues, along with a recommendation for local adoption, to the governor and the legislature and shall post the model policy on its website by January 1, 200