Authenticated PDF VersionPursuant to 14 Del.C. §§122(b)(2) and 406A, this regulation sets forth the health examination and screening requirements for students seeking to enroll or enrolled in Delaware public schools.
The following words and terms, when used in this regulation, have the following meaning:
“Health examination” means the medical examination done by a healthcare provider to determine health status and conditions.
"Healthcare provider" means a currently licensed physician, advanced practice nurse, nurse practitioner, or physician's assistant.
“Lead screening” means a capillary blood lead test, including where a drop of blood is taken from a finger or heel of the foot (16 Del.C. §2601(b)(5)).
"Local Education Agency" or "LEA" means a public board of education or other public authority legally constituted within Delaware for either administrative control or direction of, or to perform a service function for, public elementary or secondary schools in a school district, or for a combination of school districts. The term includes an educational service agency and any other public institution or agency having administrative control and direction of a public elementary school or secondary school.
"Oral health screening" means the screening done by a dental hygienist or dentist coordinated with the school by the Bureau of Oral Health and Dental Services.
“School enterer” means any child between birth and 20 years inclusive enrolling and attending a Delaware public school district or public school for the first time, including but not limited to, foreign exchange students, immigrants, students from other states or territories, and children entering from non-public schools.
“Screening” or “screenings” means the vision, hearing, postural gait, lead, and oral health screenings performed by the school nurse or other qualified healthcare professional, as provided in this regulation.
3.0 Health Examinations
3.1.3 Notwithstanding subsections 3.1.1 and 3.1.2, all students must meet the requirements under 14 DE Admin. Code 804 Immunizations.
3.1.4 The requirement for the health examination may be waived for students whose parent, guardian or relative caregiver as defined in 14 Del.C. §202(f), or the student if 18 years or older, or an unaccompanied homeless youth (as defined by 42 USC §11434a) presents a written declaration acknowledged before a notary public, that because of individual religious beliefs, they reject the concept of health examinations.
3.1.7 The school nurse shall record all findings within the student’s electronic health record (see 14 DE Admin. Code 811) and maintain the original copy in the child’s medical file.
Non regulatory note: See 14 DE Admin. Code 1034 DIAA Health and Safety Requirements for physical or health examination requirements associated with participation in interscholastic sports.
4.1 Vision and Hearing Screening
4.1.2 The school nurse shall record the results of the vision and hearing screenings within the student’s electronic health record (see 14 DE Admin. Code 811) and shall notify the parent, guardian or relative caregiver as defined in 14 Del.C. §202(f), or the student if 18 years or older, or an unaccompanied homeless youth (as defined by 42 USC §11434a) if the student has a suspected problem.
4.2 Postural and Gait Screening
4.2.2 The school nurse shall record the findings of the postural and gait screening within the student’s electronic health record (see 14 DE Admin. Code 811) and shall notify the parents, guardian or relative caregiver as defined in 14 Del.C. §202(f), or the student if 18 years or older, or an unaccompanied homeless youth (as defined by 42 USC §11434a) if a suspected deviation has been detected. If a suspected deviation is detected, the school nurse shall refer the student for further evaluation through an on-site follow up evaluation or a referral to the student’s healthcare provider.
4.3.1 School enterers at kindergarten or at age 5 or prior, shall be required to provide documentation of lead screening as per 16 Del.C. §2603. Except in the case of enrollment in kindergarten, the screen may be done 60 calendar days of the date of enrollment.
4.3.2 The school nurse shall document the lead screening within the student’s electronic health record. See 14 DE Admin. Code 811.
Non-regulatory note: The Childhood Lead Poisoning Prevention Act, 16 Del.C. Ch. 26, requires healthcare providers to order lead screening for children at or around 12 and 24 months of age. A child is not required to undergo the screening if the child's parent or guardian objects on the grounds that the screening conflicts with the parent's or guardian's religious beliefs. 16 Del.C. §2602(e).
4.4.1 Beginning with the 2024-2025 school year, and for each school year thereafter subject to 14 Del.C. §4123(f), each school, through the Bureau of Oral Health and Dental Services shall provide an oral health screening to each student enrolled in kindergarten by the last student attendance day of the school year.
Non-regulatory note: Pursuant to 14 Del.C. §4123(e), the Bureau of Oral Health and Dental Services is required to inform a parent or guardian of each student's oral health status by sending home, with the student, a copy of the dental screening results and to refer students who need a dental referral or restorative care to a dentist.
6.2 Special consideration should be given to the following populations:
6.2.3 Military-Connected Youth - In accordance with the provisions of 14 Del.C. Ch. 1, Subchapter III-A Interstate Compact on Education For Children of Military Families (MIC3) and its enabling regulation, a school enterer or secondary school student who is subject to MIC3 shall be allowed 30 calendar days from the date of enrollment or within such time as is reasonably determined under the rules promulgated by the Interstate Commission, to obtain or to initiate a series of immunizations required by this regulation. The Delaware public school nurse of the enrolling school shall work with the parent or guardian of the school enterer to obtain the necessary immunization records as soon as possible.
