Laws, Rules, and Regulations

• Section 190.921, RSMo
• Section 190.092, RSMo, Defibrillators, use authorized when, conditions, notice--good faith immunity from civil liability, when.

• Section 167.208, RSMo, requires each school district to adopt a policy on allergy prevention and response with priority given to addressing potentially deadly food-borne allergies; the policy and procedure must be in place by July 1, 2011.
• Section 167.627, RSMo, addresses possession and self-administration of medications in school.
• Section 167.621, RSMo, addresses the authorization of medications in schools. Persons providing health services under sections 167.600 to 167.621 shall obtain authorization from a parent or guardian of the child before providing services as provided by section 431.061, RSMo.
• Section 167.630, RSMo, This act authorizes school contracted agents trained by a nurse to administer an epinephrine auto syringe on any student who is having a life-threatening anaphylactic reaction. This act also provides that trained contracted agents shall be immune from civil liability in the administration of a prefilled auto syringe.

• Section 167.635 RSMo Asthma-related rescue medications, school nurse may be authorized by school board to maintain, procedure.
• Each school board may authorize a school nurse licensed under chapter 335 who is employed by the school district and for whom the board is responsible to maintain a supply of asthma-related rescue medications at the school. The nurse shall recommend to the school board the quantity of medication the school should maintain.
• To obtain asthma rescue medications for a school district, a prescription written by a licensed physician, a physician's assistant, or nurse practitioner is required. For such prescriptions, the school district shall be designated as the patient, the nurse's name shall be required, and the prescription shall be filled at a licensed pharmacy.
• A school nurse or other school employee trained by and supervised by the nurse shall have the discretion to use asthma-related rescue medications on any student the school nurse or trained employee believes is having a life-threatening asthma episode based on the training in recognizing an acute asthma episode. The provisions of Section 167.624 concerning immunity from civil liability for trained employees administering lifesaving methods shall apply to trained employees administering an asthma-related rescue medication under this section.

• §MO St. §431.068 Any person 17 years of age or older may donate blood voluntarily; any person 16 years of age may donate blood with written permission or authorization from his/her parent or guardian.

• Section 160.261, RSMo, This act requires school districts notify parents and receive written permission before using corporal punishment. The act repeals language related to the jurisdiction of the Children's Division within the Department of Social Services and its ability to investigate reports of alleged child abuse by personnel of a school district, a teacher, or other school employee. It also repeals language related to how a school and school district are to handle reports of alleged child abuse.

• Section 170.310, RSMo, CPR instruction and training requirements for grades 9-12

• HB675 management of diabetes in elementary and secondary schools
• Section 161.450.1, RSMo This section shall be known as "Cade's Law". The department of elementary and secondary education shall develop and adopt rules relating to a physical fitness challenge for elementary-, middle-, and high school-level students. The challenge shall include, but not be limited to, elements that address physical conditioning, flexibility, strength, and aerobic capacity and shall recognize individual, team, and school-wide performance.
• Section 167.803, RSMo Training of school employees, content, requirements.
• Section 167.806, RSMo Plan to be submitted by parent or guardian of student with diabetes--review by school.
• Section 167.809.1, RSMO Diabetic care may be provided to students, when, trained personnel to be on site.
• Section 167.812.1, RSMo Diabetic care not practice of nursing, when--health care professionals may provide training.
• Section 167.818, RSMo Student may perform certain diabetic care for self.
• Section 167.821, RSMo Immunity from liability.
• Section 167.824.1, RSMo Rulemaking authority.

• MO St. §311.310 The drinking age is 21

• MO St. §431.061(4)(c) Any minor may consent to any medical, surgical, or other treatment or procedures in case of drug or substance abuse.
• MO St. §431.062 Any physician or surgeon who provides medical or surgical care under 431.061(4) to a minor may, with or without the minor's consent, advise the parent/guardian of the health care given or needed if the provider knows the whereabouts of the parent/guardian. If the minor is found not to be suffering from drug abuse, then no information shall be given to the parent or any other person

• MO St. §431.063 Consent is implied in emergency care

• Section 190.255, RSMo, Any qualified first responder may obtain and administer naloxone to a person suffering from an apparent narcotic or opiate-related overdose in or to revive a person.
• Section 195.206, RSMo, Notwithstanding any other law or regulation to the contrary, it shall be permissible for any person to possess an opioid antagonist or an addiction mitigation medication. Any person who, acting in good faith and with reasonable care, administers an opioid antagonist to another person whom the person believes to be suffering an opioid-related overdose shall be immune from criminal prosecution, disciplinary actions from his or her professional licensing board, and civil liability due to the administration of the opioid antagonist.
• National School Boards Association: Drugs, Substance Abuse, and Public Schools - A Legal Guide for School Leaders Amidst Evolving Social Norms With a foreword by the National Association of School Nurses(2019)

• Section 573.550, RSMo, This act provides that a person commits the offense of providing explicit sexual material to a student if such person is affiliated with a public or private elementary or secondary school in an official capacity and, knowing of its content and character.

• §MO St. §191.656(2) No person is liable for disclosure of HIV test results to the parents/guardian of an unemancipated, minor patient. This does not impose a duty on any person to disclose the results of an individual's HIV testing to a parent.
• §MO St. §191.659 An unemancipated minor who is a victim of any sexual offense and their parents or custodian shall be notified of the confirmed positive HIV results of the offender.
• §MO St. §191.689 Only after a school has adopted a policy consistent with CDC recommendations shall the Department of Health notify the superintendent or chief administrative officer that an HIV+ child attends in their district or school.

**Others may be informed on a need-to-know basis in order to provide proper health care and to determine the fitness of a child to attend school

• Section 167.183, RSMo: Immunizations records, disclosure

• Section 160.077, RSMo

Beginning in the 2023-24 school year and for each subsequent school year, each school shall provide drinking water with a lead concentration level below five parts per billion in sufficient amounts to meet the drinking water needs of all students and staff

• MO St. §§431.065 & 431.061(3) Any minor who has been married is considered an adult for the purpose of entering into a contract for surgical, medical, or other treatment or procedures for himself or herself or their spouse

• Section 170.047, RSMo, This act shall be known as the “Jason Flatt/Avery Reine Cantor Act” and addresses youth suicide awareness and prevention training for educators.
• Section 170.048, RSMo, This act requires a public school or charter school with pupils in grades seven to twelve that issues pupil or student identification cards to print the 3-digit dialing code that directs calls and routes text messages to the Suicide and Crisis Lifeline, 988.
• Section 170.307, RSMo, For school year 2023 and each school year thereafter, upon graduation from high school, pupils in public schools and charter schools shall have received mental health awareness training given any time during a pupil’s four years of high school.

• MO St. §431.056A minor can contract for housing, employment, purchase an automobile, receipt of a student loan, admission to high school or postsecondary school, obtaining medical care, establishing a bank account and admission to a shelter for domestic violence or homeless shelter if the minor is 16 or 17, homeless, not under DFS or juvenile court, is self-supporting and has parental consent (expressed or implied) to living independently

• MO St. §§431.065.1 & 431.061(2) and (3) Any minor parent or legal custodian is considered an adult for the purpose of entering into a contract for surgical, medical, or other treatment or procedures for himself or herself and his or her child in his or her legal custody

• Section 335.075, RSMo, Verification of licensure prior to hiring
• Section 335.076, RSMo, Title protection of nurse, RN, LPN and APRN
• Section 335.096, RSMo, Violation of title protection
• Nursys - Database for verification of nurse licensure

• Section 170.311, RSMo, Organ Donation Education

• MO St. §431.061(4)(a) Any minor may consent to any medical, surgical, or other treatment or procedures in case of pregnancy, excluding abortion

• Section 167.850, RSMo, Under this act, the Commissioner of Education may approve and authorize up to four pilot recovery high schools to be established and operated by individual public school districts or groups of such districts.

In addition, Missouri law requires that LEAs submit an incident report to DESE within 30 days of any incident referenced in the policy. DESE will use the Tiered Monitoring web application to collect Seclusions and Restraint Incident Reports from LEAs. As part of the required reporting, LEAs must include a copy of the incident report provided to the parent or legal guardian of the student involved. Collection of Seclusion and Restraint Incident Reports began July 1, 2022. Reporting instructions and a template for use in reporting multiple incidents is available on the DESE website.

Section 160.263, RSMo, requires local boards of education to adopt such a policy.

• SB710 Section 167.625, RSMo This section shall be known as "Will's Law", ensuring school nurses have plans in place to respond to students with epilepsy and other seizure disorders and requiring school personnel to complete seizure-response training every two years.
• Will’s Law Overview
• Will’s Law Presentation

• MO St. §431.061(4)(b) Any minor may consent to any medical, surgical, or other treatment or procedures in case of venereal disease.
• MO St. §431.062 Any physician or surgeon who provides medical or surgical care under 431.061(4) to a minor may, with or without the minor's consent, advise the parent or guardian of the health care given or needed if the provider knows the whereabouts of the parent or guardian. If the minor is found not to have a venereal disease, then no information shall be given to the parent or any other person

How long do I keep student health records?
The Missouri Secretary of State website includes Guidelines for Records Retention for local government records and Public schools. The same schedule can be found in the Manual for School Health (page41) available for download.