HB2448 - 562R

Be it enacted by the Legislature of the State of Arizona:

Section 1. Title 15, chapter 2, article 2, Arizona Revised Statutes, is amended by adding section 15-249.19, to read:

START_STATUTE15-249.19. School-based health centers; parental consent; allowable health care services; medical records; grant program; annual report; fund; definition

A. A school district or charter school may contract with a health care provider, health system or community partner to establish a school-based health center in or near a school facility for the purpose of providing services beyond the scope of school nursing services, subject to the following requirements:

1. The school-based health center is a separate legal entity from the public school and is administered by a health care provider, health system or community partner.

2. Student participation in services provided by a school-based health center is voluntary. A school-based health center, school district or charter school may not offer an incentive to a student or parent of a student in exchange for the student's participation in services provided by the school-based health center.

3. A school-based health center provides comprehensive primary health care services during school hours to students in accordance with established standards, community practice, legal reporting requirements and other laws of this state, including parental consent and notification requirements that are consistent with federal laws.

4. All services THAT are provided at a school-based health center are provided by a licensed health care professional in accordance with applicable laws.

5. EAch health care professional in a school-based health center maintains medical records in accordance with the health insurance portability and accountability act of 1996 (P.L. 104-191; 110 Stat. 1936) and any federal regulations adopted to implement the health insurance portability and accountability act of 1996.

6. The school-based health center accepts payment FOR services through medical billing, private pay and financial assistance.

7. The school-based health center provides health care services to patients regardless of ability to pay.

8. All employees of the school-based health center are subject to the same fingerprint check or fingerprint clearance card requirements that the school district or charter school applies to noncertificated personnel in the school district or charter school pursuant to sections 15-183 and 15-512.

9. Except as required by law, a school district, charter school or corporation may not access a student's medical records.

10. A school-based HEALTH center may not perform abortion services.

B. A health care professional in a school-based health center may provide school nursing services, including:

1. Hearing evaluation services pursuant to title 36, chapter 7.2, article 1.

2. Vision screening services pursuant to title 36, chapter 7.2, article 2.

3. Basic first aid.

4. Contacting a student's parents if the student is ill or injured.

5. Coordinating emergency services for a student as needed.

6. Dispensing over-the-counter medications. FOr the purposes of this paragraph, the health care professional shall obtain consent from a student's parent before dispensing medication to the student.

7. Dispensing prescription medication according to the prescribing health care professional's instructions and, if dispensing prescription medication to a student, with prior consent of the student's parent as provided in section 15-344.

C. If health care services are provided to a patient in a school-based health center through telehealth, the treating health care professional must obtain verbal or written informed consent from the patient or the patient's health care decision maker before providing the health care services and must document the informed consent in the patient's medical records.

D. Notwithstanding any other law, a school-based health center, including any health care professional in a school-based health center, may not provide or arrange any of the following services for a student without first obtaining written or verbal consent from the student's parent and, if consent is obtained through a telehealth visit, verifying the parent's identity:

1. Mental health screening or mental health treatment. This paragraph does not apply if an emergency exists that requires a health care professional to perform mental health screening or provide mental health treatment to prevent serious injury to or save the life of the student or another person.

2. Initiating or conducting a telehealth appointment with a health care professional.

3. DIAGNOSING or treating a sexually transmitted infection.

4. Providing substance use counseling or treatment.

5. Providing pregnancy testing.

6. Providing prenatal care.

7. Providing contraceptives, including emergency contraception.

8. Administering vaccines, including immunization against the human papillomavirus.

E. If the patient in a school-based health center is a student, the following requirements apply:

1. The student's parent or an adult approved by the student's parent must be present, physically or virtually, when the student receives health care services. A student's parent may waive the requirement prescribed in this paragraph.

2. If health care services are provided to a student through telehealth, the health care provider shall do both of the following:

(a) Obtain written informed consent from the student's parent before providing the health care services. For the purposes of this subdivision, written informed consent may be provided electronically.

(b) Enter a full summary of the appointment into the student's medical records and provide a copy of the summary to the student's parent.

3. The school-based health center shall provide the student's parent with access to all of the student's written records, electronic records and electronic accounts that are maintained by the school-based health center, including:

(a) Counseling records.

(b) Psychological records.

(d) Clinic notes.

(e) Health and immunization information, including medical records that are maintained by a health clinic or medical facility that is operated or controlled by the school district or charter school or that is located on the school district's or charter school's property.

F. A school district or charter school that has established or is seeking to establish a school-based health center pursuant to subsection A of this section may not enter Any contract or agreement, including an agreement in connection with a grant program, that requires the school district or charter school to violate this section.

G. A student's parent may bring an action against a school-based health center in the superior court in the county in which the school district or charter school is located for failure to comply with any requirement prescribed in subsection D or E of this section. This subsection does not preclude any other remedies available to a student's parent at law or in equity.

H. The school-based health center grant program is established within the department of education. The department may adopt rules or policies to implement this program, including grant application requirements. The department may award a grant to a school district or charter school in this state for the purpose of establishing a school-based health center pursuant to subsection A of this section. A school district or charter school that receives a grant pursuant to this subsection must annually report to the department all of the following information:

1. For students who received health care services in the school-based health center during the previous year:

(a) The number of students who received telehealth services.

(b) The average time that each student spent in the health office.

(d) The average number of school absences after a student received health care services.

(e) The percentage of students who returned to class on the same day that the student received health care services.

(f) The percentage of appointments in which a student's parent was present.

(g) The percentage of appointments in which a student's parent was not present.

2. Survey results regarding parents' satisfaction with the school-based health center and the health care services provided.

3. Survey results regarding schoolteachers', employees' and administrators' satisfaction with the school-based health center and the health care services provided.

I. The school-based health center grant program fund is established consisting of legislative appropriations and grants, gifts, devises and donations from any public or private source. The department of education shall administer the fund. Monies in the fund are continuously appropriated and are exempt from the provisions of section 35-190 relating to lapsing of appropriations.

J. For the purposes of this section, "parent" means a parent, guardian or legal custodian of a student who is not an emancipated minor. END_STATUTE

Sec. 2. Appropriation; department of education; student-based health centers

The sum of $3,000,000 is appropriated from the state general fund in fiscal year 2024-2025 to the school-based health center grant program fund established by section 15-249.19, Arizona Revised Statutes, as added by this act.

Sec. 3. Intent

The legislature intends to reduce the amount of time that students spend out of the classroom because of injury or illness by providing infrastructure for integrated health care services to be provided at school district and charter school campuses through school-based health centers. The establishment of school-based health centers allows school personnel to focus on administrative duties, school curricula and instructional time.