8 CRR-NY 136 Health Services
Disclaimer: These Rules of the Regents and Regulations of the Commissioner of 糖心少女 ("regulations") are unofficial, and are presented for general informational purposes as a public service. Although reasonable efforts have been made to ensure that these regulations are current, complete and accurate, the State 糖心少女 Department does not warrant or represent that they are current, complete and accurate. These regulations are subject to change on a regular basis. Readers are advised to consult Title 8 of the Official Compilation of Codes, Rules and Regulations of the State of New York (8 NYCRR), published by the Department of State, and the State Register for the official exposition of the text of these regulations, as well as for amendments and any subsequent changes or revisions thereto.
Note: For a printable version of this regulation, please see the Commissioner's Regulation Section 136.
8 NYCRR 136.1
Section 136.1. Definitions
Definitions as used in this Part:
(a) School personnel means persons employed by school authorities in conducting the schools.
(b) Health professionals means persons duly licensed or otherwise authorized to practice a health profession pursuant to applicable law, including, but not limited to, physicians, registered professional nurses, nurse practitioners, physicians assistants, optometrists, dentists, dental hygienists, dietitians and nutritionists, and audiologists.
(c) School nurse means a registered professional nurse.
(d) Director of school health service means a qualified physician, or a nurse practitioner to the extent authorized by article 139 of the 糖心少女 Law and consistent with a written practice agreement, to the extent required, pursuant to 糖心少女 Law, section 6902(3), who is duly licensed pursuant to applicable law, and who is employed by the school district to perform any duties conferred on the school physician or school medical inspector under any provision of law, to perform and coordinate the provision of health services in the public schools, and to provide health appraisals of students attending the public schools in the city or district.
(e) School health services shall mean the several procedures, including, but not limited to, medical examinations, dental inspection and/or screening, scoliosis screening, vision screening and audiometer tests, designed to determine the health status of the student; to inform parents or other persons in parental relation to the student, pupils and teachers of the individual student's health condition subject to Federal and State confidentiality laws; to guide parents, students and teachers in procedures for preventing and correcting defects and diseases; to instruct the school personnel in procedures to take in case of accident or illness; to survey and make necessary recommendations concerning the health and safety aspects of school facilities and the provision of health information.
(f) Treatment includes but is not limited to the efforts to cure, care, ameliorate, manage or prevent diseases, disorders or injuries in need of attention wherein the student, for the most part, is a passive recipient.
(g) Commencement of the school year shall mean the first day of the school year in which students are in attendance.
(h) Thirty days or 90 days shall mean, respectively, 30 calendar days or 90 calendar days.
(i) Health certificate shall mean a health examination recorded on a form prescribed by the Commissioner, describing the health condition of a student when the health examination was made and whether or not the student is in fit condition to permit his or her attendance at the public schools in accordance with the provisions of section 136.3(c) of this Part.
(j) Dental health certificate shall mean a statement describing the dental health condition of the student when the dental health assessment was made, describing if a student is in fit condition of dental health to permit his or her attendance at the public schools in accordance with the provisions of section 136.3(k) of this Part.
8 NYCRR 136.2
Section 136.2. General regulations
(a) All schools under the jurisdiction of the State 糖心少女 Department shall provide a program of health services.
(b) School health services shall be provided by each school district for all students attending the public schools in this State, except in the city school district of the city of New York, in accordance with law and the regulations. School health services shall include the services of a registered professional nurse, if one is employed, and shall also include such services as may be rendered as provided herein in examining students for the existence of disease or disability and in testing the eyes and ears of such students.
(c) The trustees or board of education of each school district shall employ, at a compensation to be agreed upon by the parties, a director of school health services.
(d) It shall be the duty of trustees and boards of education:
(1) to provide approved and adequate personnel and adequate facilities for treatment;
(2) to maintain for each student cumulative records covering the essential features of the health services program; and
(3) to make such reports to the department as may be required on forms prescribed by the Commissioner.
8 NYCRR 136.3
Section 136.3. School health services
Effective September 29, 2021
(a) General duties of trustees and boards of education. It shall be the duty of the trustees and boards of education:
(1) to provide and maintain a continuous program of school health services in accordance with this section;
(2) except where otherwise prohibited by law, to advise, in writing, the parent of, or other persons in parental relation to, each student in whom any aspect of the total school health program indicates such student has defective sight or hearing, or a physical disability or other condition which may require professional attention with regard to health;
(3) to provide, where the exigencies warrant, relief in situations where the student would otherwise be deprived of the full benefit of education through inability to follow the instruction offered;
(4) to maintain a program of education for the purpose of informing the school personnel, parents, non-school health agencies, welfare agencies and the general public regarding school health conditions, services and factors relating to the health of students;
(5) to provide for guidance to parents, students and teachers in procedures for preventing and correcting defects and diseases and in the general improvement of the health of students;
(6) to furnish instruction to school personnel in procedures to follow in case of accident or illness;
(7) to provide inspections and supervision of the health and safety aspects of the school plant;
(8) to provide health examinations before participation in strenuous physical activity and periodically throughout the season as necessary; and
(9) to provide health examinations necessary for the issuance of employment certificates, vacation work permits, newspaper carrier certificates and street trades badges.
(b) Examination and health history.
(1) Except in the city school district of the city of New York, it shall be the duty of the trustees and boards of education to require each student enrolled in the public school to have a satisfactory health examination conducted by a duly licensed physician, physician assistant or nurse practitioner, upon the student's entrance in such school at any grade level and for each student entering pre-kindergarten or kindergarten and in the 1st, 3rd, 5th, 7th, 9th and 11th grades. Such examination shall be acceptable for purposes of this section if it is administered not more than 12 months prior to the commencement of the school year in which the examination is required, provided however, that for the 2020-2021 school year where a student is unable to obtain a health examination in the required grade pursuant to this paragraph due to the COVID-19 crisis, such student shall obtain such health examination by September 1, 2021.
(2) An examination and health history of any student may be required by local school authorities at any time in their discretion to promote the educational interests of such student.
(3) In all school districts, the physician, physician assistant or nurse practitioner administering such examination shall determine whether a one-time test for sickle cell anemia is necessary or desirable and, if so determined, shall conduct such test and include the results in the health certificate prepared in accordance with subdivision (c) of this section, provided that nothing herein shall be deemed to require that a student be tested more than once during the period the student is eligible to attend a public school.
(c) Health certificates and proof of immunization.
(1) Health certificates. It shall be the duty of the trustees and boards of education to require that each student, within 30 days after his or her entrance into school and within 30 days after his or her entry into pre-kindergarten or kindergarten, 1st, 3rd, 5th, 7th, 9th and 11th grades, submit to the principal or the principal's designee a health certificate that meets the requirements of this paragraph, provided that no health certificate shall be required of a student for which an accommodation for religious beliefs is made pursuant to subdivision (f) of this section, provided further, however, that for the 2020-2021 school year where a student is unable to obtain a health certificate in the required grade pursuant to this paragraph due to the COVID-19 crisis, such student shall submit such health examination by September 1, 2021.
(i) The health certificate shall:
(a) be on a form prescribed the Commissioner and signed by a duly licensed physician, physician assistant, or nurse practitioner, who is:
(1) authorized by law to practice in this State, and consistent with any applicable written practice agreement; or
(2) authorized to practice in the jurisdiction in which the examination was given, provided that the Commissioner has determined that such jurisdiction has standards of licensure and practice comparable to those of New York;
(b) describe the condition of the student when the examination prescribed in subdivision (b) of this section was听听听听 made, which examination shall not have been given more than 12 months prior to the commencement of the
school year in which the examination is required;
(c) state the results of any test conducted on the student for sickle cell anemia pursuant to this section;
(d) state whether such student is in a fit condition of health to permit his or her attendance at the public schools and, where applicable, whether the student has defective sight or hearing, has received scoliosis screening in the grades required by subdivision (e) of this section or has any other physical disability which may tend to prevent the student from receiving the full benefit of school work or from receiving the best educational results, or which may require a modification of such work to prevent injury to the student;
(e) Each such certificate shall also state the student's body mass index (BMI) and weight status category in accordance with 糖心少女 Law section 903. For purposes of this subdivision, BMI is computed as the weight in kilograms divided by the square of height in meters or the weight in pounds divided by the square of height in inches multiplied by a conversion factor of 703. Weight status categories for children and adolescents shall be as defined by the Commissioner of Health.
(ii) The health certificate shall be filed in the student's cumulative record.
(iii) The principal or the principal's designee shall send a notice to the parents of, or person in parental relationship to, any student who does not present a health certificate, unless he or she has been accommodated on grounds of religious beliefs pursuant to subdivision (f) of this section, that if the required health certificate is not furnished within 30 days from the date of such notice, an examination by health appraisal will be made of such student by the director of school health services pursuant to subdivision (d) of this section.
(2) Immunizations. It shall be the duty of the trustees and boards of education to require that every student entering or attending school provide proof of immunization against certain diseases in accordance with the provisions of Public Health Law section 2164(7)(a).
(d) Examination by health appraisal.
(1) Each principal or principal's designee shall report to the director of school health services having jurisdiction over such school, the names of all students who are required to and have not furnished health certificates pursuant to subdivision (c) of this section, or who are students with disabilities.
(2) The director of school health services shall cause such students to be separately and carefully examined and tested to ascertain whether any such student has defective sight or hearing, or any other physical disability which may tend to prevent the student from receiving the full benefit of school work or from receiving the best educational results, or which may require a modification of such work to prevent injury to the student.
(3) Each examination shall also include a calculation of the student's body mass index (BMI) and weight status category in accordance with 糖心少女 Law section 904. For purposes of this subdivision, BMI is computed as the weight in kilograms divided by the square of height in meters or the weight in pounds divided by the square of height in inches multiplied by a conversion factor of 703. Weight status categories for children and adolescents shall be as defined by the Commissioner of Health.
(4) In all school districts, the physician, physician assistant or nurse practitioner administering such examination shall determine whether a one-time test for sickle cell anemia is necessary or desirable and, if so determined, shall conduct such test and include the results in the health certificate prepared in accordance with subdivision (c) of this section, provided that nothing herein shall be deemed to require that a student be tested more than once during the period the student is eligible to attend a public school.
(5) If it should be ascertained, upon such test or examination, that any students have defective sight or hearing, or other physical disability, including sickle cell anemia, the principal or principal's designee shall notify the student's parents or persons in parental relation as to the existence of such disability. If the parents or persons in parental relation are unable or unwilling to provide the necessary relief and treatment for such students, such fact shall be reported by the principal or principal's designee to the director of school health services, whose duty it shall be to provide relief for such students.
(1) It shall be the duty of trustees and boards of education to provide:
(i) scoliosis screening once each school year for male students in grade 9, and for female students in grades 5 and 7, unless the scoliosis screening is documented on the student's health certificate. Such screening shall include the examination of the student's unclothed back while bending forward at the waist, including the cervical, thoracic, lumbar and sacral vertebral segments by viewing from the front, back and sides under adequate illumination and observing the existing range of motion of the spine in all directions. Such screening shall be provided by licensed health professionals with appropriate training, including, but not limited to, a registered professional nurse, a school nurse teacher, a nurse practitioner, a physician assistant, a physical therapist, or a physician. The positive results of any such screening examinations for the presence of scoliosis shall be in writing and the parent of, or person in parental relation to, any student in whom the presence of scoliosis is found shall be advised of such results by the school authorities within 90 days after such finding. The requirements of this subparagraph relating to examination for scoliosis may be waived by the Commissioner upon the filing with the Commissioner of a resolution, duly adopted by a board of education following a public hearing on such proposed resolution, stating that the school district does not have the capability to comply with this subparagraph relative to the examination for scoliosis and that such compliance would place a financial burden upon the school district. The district shall provide, in addition to the resolution, the date of the public hearing, a report of the findings from the hearing. The resolution shall be filed no later than October 1st of each school year. A waiver of this requirement by the Commissioner shall be valid for one school year;
(ii) vision screening, if not documented on the health certificate, to all students who enroll in a school of this state including at a minimum color perception, distance acuity, and near vision within six months of admission to the school; in addition, all students shall be screened for distance acuity and near vision in grades pre-kindergarten or kindergarten, 1, 3, 5, 7 and 11 and at any other time deemed necessary; the results of all such vision screening examinations shall be in writing and shall be provided to the pupil's parent or person in parental relation and to any teacher of the pupil within the school while the pupil is enrolled in the school;
(iii) hearing screening, if not documented on the health certificate to all students within six months of admission to the school and in grades pre-kindergarten or kindergarten, 1, 3, 5, 7 and 11, and at any other time deemed necessary; such screening shall include, but not be limited to, pure tone screening; the results of any such hearing tests requiring a follow up examination shall be in writing and shall be provided to the pupil's parent or person in parental relation and to any teacher of the pupil within the school while the pupil is enrolled in the school.
(2) The results of all health screenings (dental, hearing, vision and scoliosis) shall be recorded in the student's cumulative health record which shall be maintained by the school for at least as long as the minimum retention period for such records, as prescribed by the Commissioner pursuant to article 57-A of the Arts and Cultural Affairs Law. The trustees or board of education shall ensure that the health professional making the examination shall sign the cumulative health record and make appropriate recommendations;
(3) The hearing, vision, and scoliosis screenings required pursuant to paragraph (1) of this subdivision shall be waived for the 2020-21 school year due to the COVID-19 crisis, unless such screening has otherwise been deemed necessary.
(f) Accommodation for religious beliefs. Notwithstanding the provisions of this section, no health examinations, health history, examinations for health appraisal, screening examinations for sickle cell anemia and/or other health screenings shall be required where a student or the parent or person in parental relation to such student objects thereto on the grounds that such examinations, health history and/or screenings conflict with their genuine and sincere religious beliefs. A written and signed statement from the student or the student's parent or person in parental relation that such person holds such beliefs shall be submitted to the principal or the principal's designee in which case the principal or principal's designee may require supporting documents.
(g) Student health records. The health records of individual students shall be kept confidential in accordance with the Federal Family 糖心少女al Rights and Privacy Act (FERPA) and any other applicable Federal and State laws.
(h) Exclusion from school of student with communicable disease. Whenever, upon investigation and evaluation by the director of school health services, or the school nurse, nurse practitioner, or physician assistant acting upon direction or referral of such director for assessment, care and treatment, a student in the public schools shows symptoms of any communicable or infectious disease reportable under the Public Health Law that imposes a significant risk of infection of others in the school, he or she shall be excluded from the school and sent home immediately, in a safe and proper conveyance. The director of school health services may examine any student returning to school following an absence due to illness or unknown cause, who is without a certificate from a local public health officer, a duly licensed physician, physician assistant or a nurse practitioner, to determine that such student does not pose a threat to the school community.
(i) Health examination of employees and school premises. To protect students and staff from communicable diseases, the director of school health services, a registered professional nurse, nurse practitioner or physician assistant acting upon direction or referral of such director, may make such assessments of teachers and any other school employees, school buildings and premises as, in their discretion, they may deem necessary.
(j) Condom availability. Boards of education or trustees that elect to make condoms available to pupils as part of its program of school health services shall assure that adequate personal health guidance is provided to each pupil receiving condoms in the manner prescribed by section 135.3(c)(2)(ii) of this Title.
(k) Dental health certificates.
(1) It shall be the duty of the trustees and boards of education to request that each student, within 30 days after such student's entrance into school and within 30 days after such student's entry into the 1st, 3rd, 5th, 7th and 9th grades, submit to the principal or the principal's designee a dental health certificate that meets the requirements of this subdivision; provided that no dental health certificate shall be requested of a student for which an accommodation for religious beliefs is made pursuant to subdivision (f) of this section.
(i) The dental health certificate shall:
(a) be signed by a duly licensed dentist or a registered dental hygienist who is:
(1) authorized by law to practice in this State, and consistent with any applicable written practice agreement; or
(2) authorized to practice in the jurisdiction in which the assessment was given, provided that the Commissioner has determined that such jurisdiction has standards of licensure and practice comparable to those of New York;
(b) describe the dental health condition of the student when the assessment was made, which assessment shall not have been given more than 12 months prior to the commencement of the school year in which the assessment is requested; and
(c) state whether such student is in fit condition of dental health to permit his or her attendance at the public schools.
(ii) Within 30 days after the student's entrance in such school or grades, the dental health certificate, if obtained, shall be filed in the student's cumulative health record.
(2) An examination and dental health history of any child may be requested by the local school authorities at any time in their discretion to promote the educational interests of such child.
(3) It shall be the duty of the trustees and boards of education to ensure that a notice of request for dental health certificates be distributed at the same time that parents of, or persons in parental relationship to, students are notified of health examination requirements. The notice shall include a statement that a list of dental practices, dentists and registered dental hygienists to which children may be referred for dental services on a free or reduced cost basis is available upon request at the child's schools. Such list shall be as prescribed by the Commissioner and shall be made available by school districts to parents or persons in parental relationship upon request.
8 NYCRR 136.4
Section 136.4. On-site cardiac automated external defibrillators
Effective: June 3, 2026
(a) Definitions. As used in this section:
(1) automated external defibrillator means a device as defined in Public Health Law, section 3000-b(1)(a);
(2) instructional school facility means a building or other facility maintained by a school district, a board of cooperative educational services, a county vocational education and extension board, a charter school ,or 1 a nonpublic school where instruction is provided to students pursuant to its curriculum;
(3) school-sponsored or school-approved curricular or extracurricular events or activities means events or activities of a school district, a board of cooperative educational services, a county vocational education and extension board, a charter school ,or 1 a nonpublic school that are, respectively, associated with its instructional curriculum or otherwise offered to its students;
(4) school-sponsored athletic contest means an extraclass intramural athletic activity of instruction, practice and competition for pupils in grades 4 through 12 consistent with section 135.4 of this Title.
(5) school-sponsored competitive athletic event means an extraclass interschool athletic activity of instruction, practice and competition for pupils in grades 7 through 12 consistent with section 135.4 of this Title.
(b) Each school district, board of cooperative educational services, county vocational education and extension board, charter school ,and 1 nonpublic school shall provide and maintain on-site in each instructional school facility functional cardiac automated external defibrillator equipment for use during emergencies. Each such facility shall have sufficient automated external defibrillator equipment available to ensure ready and appropriate access for use during emergencies. In determining the quantity and placement of automated external defibrillators, consideration shall be given to:
(c) Whenever an instructional school facility is used for a school-sponsored or school-approved curricular or extracurricular event or activity, the school officials and administrators responsible for such facility shall ensure the presence of at least one staff person who is trained, pursuant to Public Health Law, section 3000-b(3)(a), in the operation and use of an automated external defibrillator.
(d) During any school-sponsored athletic contest or school-sponsored competitive athletic event held at any location, school officials and administrators responsible for such contest or event shall ensure that automated external defibrillator equipment is provided on-site and that at least one staff person who is trained, pursuant to Public Health Law, section 3000-b(3)(a), in its use is present during such contest or event.
(e) Each automated external defibrillator device shall be approved by the Food and Drug Administration for adult use and/or for pediatric use, as appropriate for the population reasonably anticipated to be served by such device, and shall be used according to the manufacturer's instructions with due attention provided to operating procedures, maintenance, and expiration date. Additionally, each school district, board of cooperative educational services, county vocational education and extension board, and charter school must ensure that each automated external defibrillator device is clearly marked, accessible, and maintained consistent with guidelines set by the American Heart Association or other nationally recognized guidelines focused on emergency cardiovascular care.
(f) Pursuant to Public Health Law 搂 3000-b(3)(d), any use of an automated external defibrillator shall be immediately reported to the appropriate local emergency medical services system, emergency communications center, or emergency vehicle dispatch center as appropriate and promptly reported to the emergency health care provider.
(g) Each school district, board of cooperative educational services, county vocational education and extension board, charter school, and nonpublic school shall post a sign or notice at the main entrance to the facility or building in which the automated external defibrillator is stored, indicating the location where any such automated external defibrillator is stored or maintained in such building or facility regularly. Each automated external defibrillator must be clearly marked.
8 NYCRR 136.5
Section 136.5. Concussion management and awareness
Effective: November 1, 2023
(a) Applicability.
(1) The provisions of this section relate to pupils who have sustained, or are believed to have sustained, mild traumatic brain injuries (also referred to as a 鈥渃oncussion鈥 while receiving instruction or engaging in any school sponsored or related activity.
(2) The provisions of this section:
(i) shall apply to all school districts, charter schools, and nonpublic schools; and
(ii) shall be deemed to be the minimum standards that must be complied with; provided that nothing in this section shall prohibit any public school or nonpublic school from adopting and implementing more stringent standards.
(b) Course of instruction.
(1) Each school coach, physical education teacher, nurse and certified athletic trainer, who works with and/or provides instruction to pupils engaged in school sponsored athletic activities, shall complete, on a biennial basis, a course of instruction relating to recognizing the symptoms of mild traumatic brain injuries and monitoring and seeking proper medical treatment for pupils who suffer mild traumatic brain injuries.
(2) Components of such course shall include, but not be limited to:
(i) the definition of a mild traumatic brain injury;
(ii) signs and symptoms of mild traumatic brain injuries;
(iii) how mild traumatic brain injuries may occur;
(iv) practices regarding prevention; and
(v) guidelines for the return to school and school activities of a pupil who has suffered a mild traumatic brain injury, regardless of whether such injury occurred outside of school.
(3) Such course shall be completed by means of instruction approved by the Department including, but not limited, to courses provided online and by teleconference.
(c) Information.
(1) The Department shall post on its internet website information relating to mild traumatic brain injuries including, but not limited to:
(i) the definition of a mild traumatic brain injury;
(ii) signs and symptoms of mild traumatic brain injuries;
(iii) how mild traumatic brain injuries may occur; and
(iv) department guidelines for return to school and school activities of a pupil who has suffered a mild traumatic brain injury, regardless of whether such injury occurred outside of school.
(2) A school shall include the information required under paragraph (1) of this subdivision in any permission form or consent form or similar document that may be required from a parent or person in parental relation for a pupil's participation in interscholastic sports.
(3) A school shall include the information required under paragraph (1) of this subdivision, or reference how to obtain such information from the websites of the State 糖心少女 Department and the Department of Health, on the school's internet website if one exists.
(d) Removal from athletic activities.
(1) For purposes of this section the term 鈥渁thletic activities鈥 means participation in sessions for instruction and practice in skills, attitudes, and knowledge through participation in individual, group and team activities organized on an intramural, extramural, interschool athletic, or inclusive athletic basis to supplement regular physical education class instruction, otherwise known as extraclass periods in physical education or extraclass activities.
(2) A school shall require the immediate removal from athletic activities of any pupil who has sustained, or who is believed to have sustained, a mild traumatic brain injury. In the event that there is any doubt as to whether a pupil has sustained a concussion, it shall be presumed that the pupil has been so injured until proven otherwise.
(2)[1] No such pupil shall resume athletic activity until the pupil has been symptom free for not less than 24 hours, and has been evaluated by and received written and signed authorization from a licensed physician; and for extra class athletic activities in public schools, has received clearance from the director of school health services to participate in such activity.
(i) Such authorization shall be kept on file in the pupil's permanent health record.
(ii) The school shall follow any directives issued by the pupil's treating physician with regard to limitations and restrictions on school attendance and activities for the pupil.
(e) Concussion management team.
(1) Each school or school district, in its discretion, may establish a concussion management team.
(2) The concussion management team may be composed of:
(i) the athletic director;
(ii) a school nurse;
(iii) a district's director of school health services;
(iv) a coach of an interscholastic team;
(v) a certified athletic trainer; or
(vi) such other appropriate personnel as designated by the school or school district.
(3) The concussion management team shall oversee the implementation of subdivision (42) of 糖心少女 Law section 305 and the provisions of this section as it pertains to their associated school and may establish and implement a program which provides information on mild traumatic brain injuries to parents and persons in parental relation throughout each school year.
8 NYCRR 136.6
Section 136.6. Authorized use of epinephrine devices
Effective: July 1, 2026
(a) Definitions. As used in this section:
(1) Epinephrine device means a single-use device used for the automatic injection of a premeasured dose of epinephrine into the human body for the purpose of emergency treatment of a person appearing to experience anaphylactic symptoms approved by the United States Food and Drug Administration.
(2) Trained school personnel means any person employed by a school district, board of cooperative educational services, county vocational education and extension board, charter school or non-public elementary and secondary school, including but not limited to, health professionals who have successfully completed a training course in the use of epinephrine devices approved by the Department of Health pursuant to Public Health Law section 3000-c.
(3) Instructional school facility means a building or other facility maintained by a school district, board of cooperative educational services, a county vocational education and extension board, charter school, or non-public elementary and secondary school where instruction is provided to students pursuant to its curriculum.
(b) Each school district, board of cooperative educational services, county vocational education and extension board, charter school, and non-public elementary and secondary school may provide and maintain on-site in each instructional school facility epinephrine devices for use during emergencies in accordance with Public Health Law section 3000-c. Each such facility shall have sufficient epinephrine devices available to ensure ready and appropriate access for use during emergencies to any student or staff having symptoms of anaphylaxis, whether or not there is a previous history of severe allergic reaction. In determining the quantity and placement of epinephrine auto-injectors, consideration shall be given to:
(1) the number of students, staff and other individuals that are customarily or reasonably anticipated to be within such facility; and
(2) the physical layout of the facility, including but not limited to:
(i) location of stairways and elevators;
(ii) number of floors in the facility;
(iii) location of classrooms and other areas of the facility where large congregations of individuals may occur; and
(iv) any other unique design features of the facility.
(c) In the event of an emergency, trained school personnel or school personnel directed in a specified instance to use an epinephrine device by a health care practitioner as defined in Public Health Law section 3000-c, may administer an epinephrine device to any student or school personnel having symptoms of anaphylaxis in an instructional school facility, whether or not there is a previous history of severe allergic reaction pursuant to Public Health Law section 3000-c.
(d) School districts, boards of cooperative educational services, county vocational education and extension boards, charter schools, and non-public elementary and secondary schools in this state that are authorized to provide and maintain epinephrine auto-injectors on-site pursuant to 糖心少女 Law 搂 921-a shall provide all teachers with written informational material on the use of an epinephrine auto-injector that has been created and approved by the commissioner of health.
8 NYCRR 136.7
Section 136.7. Self-administration of certain medications by students
Effective: July 1, 2026
(a) Definitions. As used in this section:
(1) Inhaled rescue medications means a solution of a drug or a combination of drugs administered to the respiratory passages via inhalation for immediate alleviation of respiratory distress for persons with asthma or other respiratory diseases. Such medication(s) are delivered by devices approved by the United States Food and Drug Administration and include metered dose inhalers, nebulizers, and other similar devices for the delivery of respiratory medications to the respiratory passage.
(2) Epinephrine device means an automated delivery device, approved by the United States Food and Drug Administration, for administering a measured dose of the drug epinephrine.
(3) Ketone test means a blood test utilizing a drop of blood on a blood ketone test strip and a blood glucose meter or urine dipstick test utilizing a urine ketone test strip placed into the urine to determine the number of ketones present in either the blood or urine.
(4) Blood glucose test means a blood test utilizing a drop of blood on a blood glucose test strip, and a blood glucose meter to determine the blood glucose level.
(5) Insulin means insulin hormone and similar proteins used as a medication to treat diabetes.
(6) Glucagon means a hormone medication that raises the level of glucose in the blood.
(7) Duly authorized health care provider means a licensed health professional who is authorized to diagnose medical conditions and prescribe medications and treatments in accordance with his/her respective scope of practice under Title VIII of the 糖心少女 Law, including, but not limited to, a physician, physician assistant, and nurse practitioner.
(8) Cumulative health record means the record of health information maintained by the school or board of cooperative educational services for each student, which shall be kept confidential consistent with the Federal Family 糖心少女 Rights and Privacy Act (FERPA) and any other applicable Federal and State laws.
(9) Emergency action plan means a care plan written by a duly authorized health care provider, or the director of school health services or a school nurse which specifies a student's health care needs along with direction for staff to take in the event of an emergency where a licensed health professional is not present.
(10) Diabetes Management Plan means a care plan developed by a duly authorized health care provider, school health personnel, and the parent or person in parental relation that specifies in detail how the student is to manage diabetes at school including, but not limited to, detailed information for treatment of hypoglycemia and hyperglycemia by school personnel if the student becomes unable to do so independently, blood glucose range, and insulin coverage scale or correction factor orders for use by a licensed health professional if one is available.
(11) School day means any day, including a partial day, that students are in attendance at school or at a facility maintained by a board of cooperative educational services for instructional purposes.
(12) School property means in or within any building, structure, athletic playing field, playground, parking lot, or land contained within the real property boundary line of a public elementary or secondary school or a facility maintained by a board of cooperative educational services for instructional purposes, or in or on a school bus, as defined in Vehicle and Traffic Law section 142.
(13) School function means a school district or board of cooperative educational services sponsored extra-curricular event or activity regardless of where such event or activity takes place, including, but not limited to, an event or activity that may take place in another state.
(b) Students Affected with Asthma or Another Respiratory Disease.
(1) Each board of education or trustees of each school district and each board of cooperative educational services shall allow a student to carry and self-administer their prescribed inhaled rescue medication during the school day, on school property and at any school function, if the student provides the school district and/or board of cooperative educational services, as applicable, with:
(i) written consent from the parent or person in parental relation; and
(ii) written permission (also referred to as an order) and an attestation from a duly authorized health care provider confirming:
(a) that the student has a diagnosis of asthma or other respiratory disease for which inhaled rescue medications are prescribed to alleviate respiratory symptoms or to prevent the onset of exercise induced asthma;
(b) the student has demonstrated that he or she can self-administer the prescribed inhaled rescue medication effectively; and
(c) the expiration date of the order, the name of the prescribed rescue medication, the dose the student is to self-administer, times when medication is to be self-administered by the student, and the circumstances which may warrant the use of the medication.
(2) A record of such written consents shall be maintained in the student's cumulative health record.
(3) Upon written request of a parent or person in parental relation, the school district or board of cooperative educational services, as applicable, shall allow the student to maintain an extra inhaled rescue medication in the care and custody of a licensed nurse, nurse practitioner, physician assistant, or physician employed by such district or board of cooperative educational services.
(i) Nothing in this section shall require a school district or board of cooperative educational services to retain a licensed nurse, nurse practitioner, physician assistant, or physician solely for the purpose of taking custody of such extra inhaled rescue medication; or require that such licensed health professionals be available at all times in a school building for the purpose of taking custody of the inhaled rescue medication.
(ii) Such inhaled rescue medication provided by the parent or person in parental relation shall be made available to the student as needed in accordance with school policy and the written permission provided by the duly authorized health care provider.
(4) Each student with asthma or another respiratory disease who is permitted, under this section to self-administer his or her prescribed inhaled rescue medication should have an emergency action plan on file with the school district or board of cooperative educational services.
(c) Students with Allergies.
(1) Each board of education or trustees of each school district and each board of cooperative educational services shall allow a student to carry and self-administer their prescribed epinephrine device during the school day, on school property, and at any school function, if the student provides the school with:
(i) written consent from the parent or person in parental relation; and
(ii) written permission (also referred to as an order) and an attestation from a duly authorized health care provider confirming:
(a) that the student has a diagnosis of an allergy for which an epinephrine auto injector is needed for the emergency treatment of allergic reactions;
(b) the student has demonstrated that he or she can self-administer the prescribed epinephrine auto injector effectively; and
(c) the expiration date of the order, the name of the prescribed medicine, the dose the student is to self-administer and the circumstances which may warrant the use of the medication.
(2) A record of such written consents shall be maintained in the student's cumulative health record.
(3) Upon written request of a parent or person in parental relation, the school district or board of cooperative educational services, as applicable, shall allow the student to maintain an extra epinephrine device in the care and custody of a licensed nurse, nurse practitioner, physician assistant, or physician employed by such district or board of cooperative educational services.
(i) Nothing in this section shall require a school district or board of cooperative educational services to retain a licensed nurse, nurse practitioner, physician assistant, or physician solely for the purpose of taking custody of such extra epinephrine device; or require that such licensed health professionals be available at all times in a school building for the purpose of taking custody of the epinephrine device.
(ii) Such an epinephrine device provided by the parent or person in parental relation shall be made available to the student as needed in accordance with school policy and the orders prescribed by the duly authorized health care provider.
(4) Each student with allergies who is permitted under this section to self-administer his or her prescribed epinephrine device should have an emergency action plan on file with the school district or board of cooperative educational services.
(5) Licensed nurses, nurse practitioners, physician assistants, or physicians employed by schools or boards of cooperative educational services are authorized to administer prescribed epinephrine pursuant to the scope of practice of the licensed individual under Title VIII of the 糖心少女 Law, to students diagnosed with an allergy by a physician or other duly authorized health care provider and who are permitted under this section to self-administer their prescribed epinephrine device.
(6) Separate from the authority provided by section 136.6 of this Part, for students authorized to self-administer their prescribed epinephrine pursuant to this section, the board of education or trustees of each school district and board of cooperative educational services and non public schools are authorized, but not required, to have licensed registered professional nurses, nurse practitioners, physician assistants, and physicians train unlicensed school personnel to administer prescribed epinephrine auto-injectors in emergency situations, where an appropriately licensed health professional is not available, to the students authorized to self-administer their prescribed epinephrine device pursuant to this section. Training by the licensed health professional shall be provided in a competent manner and in accordance with subdivision (f) of this section.
(d) Students with Diabetes.
(1) Each board of education or trustees of each school district and each board of cooperative educational services shall allow a student to carry and self-administer their prescribed insulin through an appropriate medication delivery device, carry glucagon, and carry and use equipment and supplies necessary to check blood glucose and/or ketone levels during the school day, on school property and at any school function, if the student provides the school with:
(i) written consent from the parent or person in parental relation; and
(ii) written permission (also referred to as an order) and an attestation from a duly authorized health care provider confirming:
(a) that the student has a diagnosis of diabetes for which insulin and glucagon through appropriate medication delivery devices, and the use of equipment and supplies to check blood glucose and/or ketone levels are necessary;
(b) the student has demonstrated he or she can self-administer the prescribed insulin effectively, can self-check glucose or ketone levels independently, and can independently follow prescribed treatment orders; and
(c) the expiration date of the order, the name of the prescribed insulin or glucagon, the type of insulin delivery system, the dose or dose range of insulin the student is to self-administer, times when the insulin is to be self-administered by the student, the dose of glucagon that is to be administered, and the circumstances which may warrant the administration of the insulin by the student or the administration of glucagon to the student. The written permission must also identify the prescribed blood glucose and/or ketone test, the times testing is to be done, and any circumstances which warrant checking a blood glucose and/or ketone level.
(2) A written diabetes management plan shall be provided. A record of such written consents shall be maintained in the student's cumulative health record.
(3) Upon written request of a parent or person in parental relation, the school district or board of cooperative educational services shall allow the student to maintain extra insulin, insulin delivery system, glucagon, blood glucose meter and related supplies to treat such student's diabetes provided by the parent or person in parental relation in the care and custody of a licensed nurse, nurse practitioner, physician assistant, or physician employed by such district or board of cooperative educational services, and shall be readily accessible to such pupil.
(i) Nothing in this section shall require a school district or board of cooperative educational services to retain a licensed nurse, nurse practitioner, physician assistant, or physician solely for the purpose of taking custody of extra insulin, insulin delivery system, glucagon, blood glucose meter and related supplies to treat such student's diabetes; or require that such licensed health professionals be available at all times in a school building for the purpose of taking custody of insulin, insulin delivery system, glucagon, blood glucose meter and related supplies to treat such student's diabetes.
(ii) Such insulin, insulin delivery system, glucagon, blood glucose meter and related supplies to treat such student's diabetes provided by the parent or person in parental relation, shall be made available to the student as needed in accordance with school policy and the orders prescribed by the duly authorized health care provider.
(4) Students with diabetes may also carry food, oral glucose, or other similar substances necessary to treat hypoglycemia pursuant to district policy, provided such district policy shall not unreasonably interfere with a student's ability to treat hypoglycemia.
(5) Each student with diabetes who is permitted under this section to self-administer their prescribed insulin, carry glucagon, and carry and use equipment and supplies necessary to check blood glucose and/or ketone levels during the school day should have an emergency action plan on file with the school district or board of cooperative educational services.
(6) Licensed nurses, nurse practitioners, physician assistants, or physicians employed by school districts or boards of cooperative educational services are authorized to calculate prescribed insulin dosages, administer prescribed insulin, program the prescribed insulin pump, refill the reservoir in the insulin pump, change the infusion site, inject prescribed glucagon, teach an unlicensed person to administer glucagon to an individual, and perform other authorized services pursuant to the scope of practice of the licensed individual under Title VIII of the 糖心少女 Law, to students diagnosed with diabetes by a physician or other duly authorized health care provider and who are permitted under this section to self-administer their prescribed insulin and carry glucagon, and carry and use equipment and supplies necessary to check blood glucose and/or ketone levels during the school day. Nothing in this section shall authorize unlicensed persons to perform these services except as otherwise permitted by 糖心少女 Law section 921.
(7) The board of each school district and board of cooperative educational services and nonpublic schools are authorized, but not required to have licensed registered professional nurses, nurse practitioners, physician assistants, and physicians train unlicensed school personnel to administer prescribed glucagon in emergency situations where an appropriately licensed health care professional is not available, to students who are permitted under this section to self-administer their prescribed insulin and carry glucagon and carry and use equipment and supplies necessary to check blood glucose and/or ketone levels during the school day. Training by the licensed health professional is to be provided in a competent manner and in accordance with subdivision (f) of this section.
(e) In accordance with Title VIII of the 糖心少女 Law, only licensed health professionals whose scope of practice permits may administer medication to a student in a school setting unless otherwise permitted by 糖心少女 Law sections 6908, 907, 921 (as added by Chapter 423 of the Laws of 2014) and 921 (as added by Chapter 424 of the Laws of 2014).
(f) Training of Unlicensed Personnel to Administer Certain Medications to specific students.
(1) Prescribed Epinephrine devices. Unlicensed school personnel employed by school districts, boards of cooperative education services, and non-public schools must complete an annual course of training regarding the administration of prescribed epinephrine devices to a student. Such training must be provided and documented by an authorized licensed health professional as described in subdivision (c) of this section. Components of such training shall include, but not be limited to:
(i) Identification of the specific allergen(s) of the student(s), including review of each student's emergency action plan, if available;
(ii) signs and symptoms of a severe allergic reaction warranting administration of epinephrine;
(iii) how to access emergency services per school policy;
(iv) the steps for administering the prescribed epinephrine device;
(v) observation of the trainee using an epinephrine training device;
(vi) steps for providing ongoing care while waiting for emergency services;
(vii) notification of appropriate school personnel; and
(viii) methods of safely storing, handling, and disposing of epinephrine devices.
(2) Training of Unlicensed Personnel to Administer Prescribed Glucagon. Unlicensed school personnel employed by school districts, boards of cooperative education services, and non-public schools must complete an annual course of training regarding the administration of prescribed glucagon to a student. Such training must be provided and documented by an authorized licensed health professional as described in section (d) of this section. Components of such training shall include, but not be limited to:
(i) overview of diabetes and hypoglycemia utilizing a department approved course on glucagon administration;
(ii) review of the student's emergency care plan, if available, including treatment of mild or moderate hypoglycemia;
(iii) signs and symptoms of a severe hypoglycemia warranting administration of glucagon;
(iv) how to access emergency services per school policy;
(v) the steps for mixing, if necessary, and administering the prescribed glucagon;
(vi) observation of the trainee using a manufacturer's glucagon training device or demonstration device;
(vii) steps for providing ongoing care while waiting for emergency services;
(viii) notification of appropriate school personnel; and
(ix) methods of safely storing, handling, and disposing of glucagon and used needles and syringes.
8 NYCRR 136.8
Section 136.8. Opioid overdose prevention
(a) Definitions. As used in this section:
(1) Opioid antagonist means a drug approved by the Food and Drug Administration that, when administered, negates or neutralizes in whole or in part the pharmacological effects of an opioid, such as heroin, in the body. For use under this section, opioid antagonist shall be limited to naloxone and other medications approved by the Department of Health for such purpose.
(2) Opioid antagonist recipient (or recipient), for purposes of this section, means a school district, board of cooperative educational services (BOCES), county vocational education and extension board, charter school, non-public elementary and/or secondary school, or any person employed by such district, board or school who has been authorized by such district, board or school to participate in an opioid prevention program and has received training by a program approved pursuant to Public Health Law section 3309.
(3) Instructional school facility means a building or other facility maintained by a school district, board of cooperative educational services (BOCES), a county vocational education and extension board, charter school, or non-public elementary and secondary school where instruction is provided to students pursuant to its curriculum.
(b) School districts, boards of cooperative educational services, county vocational education and extension boards, charter schools, and non-public elementary and secondary schools may elect to participate as an opioid antagonist recipient pursuant to the provisions of Public Health Law section 3309. For school districts that choose to participate as an opioid antagonist recipient pursuant to the provisions of Public Health Law section 3309, any person employed by such entity who has been trained by a program approved under that section may administer an opioid antagonist in the event of an emergency pursuant to the requirements of Public Health Law section 3309.
(c) School districts, boards of cooperative educational services, county vocational education and extension boards, charter schools, and non-public elementary and secondary schools choosing to participate in the opioid overdose prevention program shall comply with the requirements of Public Health Law section 3309 including, but not limited to, appropriate clinical oversight, recordkeeping and reporting.
(d) School districts, boards of cooperative educational services, county vocational education and extension boards, charter schools, and non-public elementary and secondary schools who choose to participate in the opioid overdose prevention program pursuant to Public Health Law section 3309 shall provide and maintain on-site in each instructional school facility opioid antagonists. Each such facility shall have sufficient opioid antagonists available to ensure ready and appropriate access for use during emergencies to any student or staff having symptoms of an opioid overdose, whether or not there is a known previous history of opioid abuse in accordance with the provisions of Public Health Law section 3309. In determining the quantities and placement of opioid antagonists to be maintained on-site in an instructional school facility, consideration shall be given to:
(1) the number of students, staff and other individuals that are customarily or reasonably anticipated to be within such facility; and
(2) the physical layout of the facility, including but not limited to:
(i) location of stairways and elevators;
(ii) number of floors in the facility;
(iii) location of classrooms and other areas of the facility where large congregations of individuals may occur; and
(iv) any other unique design features of the facility.
(e) Nothing in this section shall require school districts, boards of cooperative educational services, county vocational education and extension boards, charter schools, and non-public elementary and secondary schools to participate in an opioid overdose prevention program, and any participation by an individual employee shall be voluntary.
(f) Use of an opioid antagonist pursuant to this section and the provisions of Public Health Law section 3309 shall be considered first aid or emergency treatment for the purpose of any statute relating to liability; provided that a school district, board of cooperative educational services (BOCES), county vocational education and extension board, charter school, non-public elementary and/or secondary school, or any person employed by such district, board or school, acting reasonably and in good faith in compliance with the provisions of Public Health Law section 3309, shall not be subject to criminal, civil or administrative liability solely by reason of such action.
8 NYCRR 136.9
Section 136.9. Sudden Cardiac Arrest
Effective: December 28, 2022
(a) Applicability.
(1) The provisions of this section relate to students who display signs or symptoms of pending or increased risk of sudden cardiac arrest while engaging in athletic activities.
(2) The provisions of this section shall apply to all school districts, charter schools, and nonpublic schools.
(b) Definitions. As used in this section:
(1) Athletic activities mean participation in sessions for instruction and practice in skills, attitudes, and knowledge through participation in individual, group and team activities organized on an intramural, extramural, interschool athletic, or inclusive athletic basis to supplement regular physical education class instruction, otherwise known as extraclass periods in physical education or extraclass activities.
(b)[2] Physical activities mean participation in physical education classes and recess or similar activities during the school day.
(c) Requirements.
(1) The Department shall post on its website information developed by the Commissioner of Health, in conjunction with the Commissioner, relating to students who exhibit signs or symptoms of pending or increased risk of sudden cardiac arrest. Such information shall include, but not be limited to:
(i) The definition of sudden cardiac arrest; and
(ii) signs and symptoms of pending or increased risk of sudden cardiac arrest.
(2) A school shall include the information required under paragraph (1) of this subdivision in any document that may be required from a parent or person in parental relation for a student's participation in interscholastic sports, including a permission or consent form.
(3) A school shall include the information required under paragraph (1) of this subdivision on its website, if in existence, or reference how to obtain such information from the webpages where such information is available from the Department and the Department of Health.
(d) Removal from athletic and physical activities.
(1) Any student who displays signs or symptoms of pending or increased risk of sudden cardiac arrest must be immediately removed from athletic activities and any person who displays signs or symptoms of pending sudden cardiac arrest must be immediately removed from physical activities.
(2) No student removed from athletic activities shall resume such activities until such student has been evaluated by and received written and signed authorization from, a licensed physician. No student removed from physical activities shall resume such activities until such student has been evaluated and received written and signed authorization from a healthcare provider. With respect to athletic activities for students attending a public school, no such student shall resume such activities until the student has also received clearance from the director of school health services to participate in such activity.
(i) Such authorization shall be kept on file in the student's permanent health record.
(ii) The school must abide by any limitations or restrictions concerning school attendance and athletic or physical activities issued by the student's treating physician or a health care provider.
8 NYCRR 136.10
Section 136.10. Statewide Protocols for Diapering and Toileting
Effective: June 3, 2026
(a) Definitions. As used in this section:
(1) Diapering means the process of disposing of soiled diapers, cleansing the skin, and reapplying a clean, dry diaper to ensure hygiene and comfort.
(2) Toileting means any activity related to a student's use of restroom facilities, including bathroom breaks, assistance with specific tasks related to toileting, and management of toileting accidents.
(3) Toilet Learning means a series of steps aimed at helping a student develop the skills and independence necessary for using the toilet.
(4) School means a school district, public school, board of cooperative educational services, special act school district, approved preschool special education programs that are not licensed or otherwise regulated by other state agencies, state-supported school, or approved private school for the education of students with disabilities.
(5) School personnel means any applicable staff members identified by the school, which may include but not be limited to teachers, aides, administrators, or nurses.
(6) Student means school-age students, prekindergarten students, and preschool students with disabilities attending a school as defined in this section.
(7) Prekindergarten students means children enrolled in State administered Universal Prekindergarten (UPK) programs overseen by a public school district.
(b) All schools shall:
(1) Define basic procedures to promote a safe and healthy environment to support diapering and toileting, and establish a plan with protocols that outline clear, age-appropriate routines to support student privacy, hygiene, and supervision. School plans must:
(i) identify staff roles and responsibilities regarding diapering and toileting within the school;
(ii) respect the privacy of each student during diapering and toileting, in accordance with age and developmental needs, while maintaining appropriate supervision;
(iii) ensure that staff provide direct and/or indirect supervision per student needs; and
(iv) be made available to parents and persons in parental relation upon request.
(2) Provide annual training on health and safety procedures to all relevant school personnel. Such training must address the following:
(i) maintenance of the diapering and toileting areas to ensure they are safe, sanitary, and hygienic for all students;
(ii) blood-borne pathogens and the use of standard precautions when dealing with blood and bodily fluids in accordance with the school's Bloodborne Pathogens (BBP) exposure control plan and training as required by 29 CFR 1910.1030; and
(iii) how to assist students with toilet learning and personal care needs in a respectful, culturally responsive, and developmentally appropriate way.
(3) Ensure that every restroom and diaper changing area is consistently maintained and cleaned, operational, safe, and appropriately equipped. Specifically, schools must ensure that:
(i) toileting and diaper changing areas are as close as possible to a sink with soap, paper towels or a hand dryer, and running water. The toileting and diaper changing areas or sinks must not be used for food preparation; and
(ii) the diaper changing area has a lined, covered container or a plastic bag designated for soiled diapers. Soiled diapers must be placed in an outdoor receptacle or one out of reach of students.
(4) Ensure that toileting facilities and changing areas provide students with privacy in a separate area that is developmentally appropriate and accessible for all students, including students with disabilities. Toilet seats and changing tables must be appropriate to the age and size of students. Schools must also ensure that there is appropriate equipment for toileting and diapering as needed for students with disabilities, including any equipment that may be required by their individualized education program (IEP) or Section 504 Plan.
(5) Provide students with access to restroom facilities during the school day, including during instructional time as needed, and extracurricular time.
(6) Provide access to diapering, toileting, or restroom use without unreasonable delay.
(7) Ensure that restrooms and changing areas are safe and clean.
(8) Ensure the following essential diapering and toileting supplies and equipment are accessible at all times as appropriate per student need:
(i) toilet paper;
(ii) soap available for handwashing;
(iii) paper towels or functional hand dryers, available for hand drying;
(iv) disposable gloves;
(v) wipes;
(vi) plastic bags for soiled clothing;
(vii) extra diapers and pull-ups; and
(viii) step stools or potty seats.
(9) Not suspend, disenroll, or exclude a student from enrollment or participation in school or school programs based on their toileting status.
(10) Manage toileting accidents with sensitivity and without punishment, exclusion, or shaming.
(11) In addition to the other provisions of this section applicable to all students, provide all supports, services, and specialized equipment to preschool and school-age students with disabilities who require assistance with toileting in accordance with their IEP or Section 504 Plan.
(12) Ensure that school personnel adhere to developmentally appropriate toileting policies and supports for younger students (three- and four-year-old prekindergarten students and preschool students with disabilities) and school-age students who require diapering and/or toileting support, recognizing the variability in toileting independence at each stage of development. Such policies should address the following:
(i) Adjust toilet learning based on individual needs; and
(ii) Work in partnership with families to support individualized toilet learning by making arrangements with families to provide an adequate supply of diapers and pull-ups and suitable clothing, so that students who soil their clothing may be changed. All clothing must be returned to parents for washing or otherwise disposed of properly.
(13) Ensure that, upon request, multilingual learners and their families receive information about toileting procedures, expectations, and supports in their preferred language.
