Massachusetts Comprehensive Health Curriculum Framework - October 1999
ORGANIZER LAW & POLICY
- INSTRUCTION & CURRICULUM
- HEALTH EDUCATION; MGL C.71, S.1 = Instruction in, Exemption from
- PHYSICAL EDUCATION; MGL C.71, S.3 = Instruction in, Exemption from
- ACADEMIC STANDARDS; MGL C.69, S.1D = Education Reform Act, Standards
- HEALTH EDUCATION GRANT; MGL C.69, S1L = Discretionary Grant
- HIV/AIDS EDUCATION; Massachusetts Board of Education Policy, 1990 = HIV/AIDS Instruction
- PARENTAL INVOLVEMENT & NOTIFICATION
- SEXUALITY EDUCATION; MGL C.71, S.32A = Parental Notification, Exemption from
- SURVEYS; U.S. Law SEC.1017, General Education Provisions Sec.439 = Available for Inspection, Exemption from
- NUTRITION; MGL C.69, S.1= Standards, Regulations, Breakfast Programs
- HEALTH SERVICES; MGL C.71, SS.53, 53A, 53B = Availability of Physicians and Nurses
- HEALTH SERVICES; MGL C.71, S.54 = Medical Personal at Interscholastic Games
- HEALTH SERVICES; MGL C.71, S.54B = Administration of Medications
- HIV/AIDS PREVENTION EDUCATION; Massachusetts Board of Education Policy, 1990 = Consideration of Condom Availability in Schools
- SAFETY; MGL C.85, S.13A = Bicycle Helmet Requirement
- SAFETY; MGL C.90, S. 7B (15)= Bus Safety
- SAFETY; MGL C.71, S.55C = Eye Protection Devices, Students and Staff
- SAFETY; MGL C.71, S.37H = Rules and Regulations, Conduct of Students and Staff
- SAFETY; MGL C.71, S.37H fract12; = Delinquency Complaint, Hearing, Suspension, Expulsion
- STUDENT POSSESSION OF WEAPONS; MGL C.71, S.37L = Reporting Requirements
- FIREARMS AT SCHOOL; MGL C.269, S.10 = Prohibits Carrying of Firearms w/out Authorization
- GUN-FREE SCHOOLS ACT; Federal, Title XIV, Part F--Gun Possession
- HAZING; MGL C.269, SS. 17, 18, 19 = Prohibits, Notification
- CHILD ABUSE AND NEGLECT; MGL C.119, S.51A; MGL C.71, S37L = Mandated Reporter, Requirements
- DOMESTIC & DATING VIOLENCE; MGL C.209A = Abuse Prevention
- DOMESTIC & DATING VIOLENCE; MGL C.265 = Crimes of Assault, S.43 = Stalking, S.22 = Rape
- SEX OFFENDERS; MGL C.6, ss178C-178O = Registry, Community Notification
- SEXUAL DISCRIMINATION & HARASSMENT; MGL C.76, S.5, Federal Title IX = Prohibited
- SEXUAL DISCRIMINATION & HARASSMENT; MGL C.151C = Harassment Defined
- SEXUAL DISCRIMINATION & HARASSMENT; MGL C.71, S.84 = Student Discipline Prohibited
- RACIAL DISCRIMINATION; Federal Title VI = Racial or National Origin Discrimination Prohibited
- DISABILITY DISCRIMINATION; Rehabilitation Act, S.504; Americans w/Disabilities Act=Prohibited
- SUBSTANCES; MGL C.71, S.37H = Publish School Policy Prohibiting Tobacco & Substances on Grounds/Events by All
- SUBSTANCES; MGL C.71, S.2A = Prohibit Student Use of Tobacco on School Grounds
- SUBSTANCES; MG. C.94C, S.32F=Prohibit Distribution of Controlled Substances to Persons Under Eighteen
- SUBSTANCES; MGL C.272, S.40A = Prohibit Alcohol on School Premises, Imprisonment, Fines, Exemptions
- DISEASE PREVENTION & CONTROL
- SICK CHILDREN; MGL C.71, S.55 = Contagious Diseases; School Attendance Regulated
- SICK CHILDREN; MGL C.71, S.55A, S.56 = Procedure for Handling Sick Children, Liability
- TUBERCULOSIS; MGL C.71, S.55B; C.69, S.1C = Examinations for Staff
- IMMUNIZATION; MGL C.76, S.15 = Vaccination and Immunization Requirements, Exemptions
- CONFIDENTIALITY & TREATMENT
- STUDENT SCHOOL RECORDS; MGL C.71, S.34D = Record Regulations (603 CMR 23.00)
- STUDENT SCHOOL RECORDS; 603 CMR 23.07 = Access by Third Parties
- PSYCHOLOGICAL CARE; MGL C.112, S.129A = Confidential Communication
- HIV/AIDS TESTING; MGL C.111, S.70F = Confidentiality, Informed Consent
- MEDICAL & DENTAL CARE; MGL C.112, S.12F = Minor Consent to Diagnosis or Treatment
- MEDICAL & DENTAL CARE; MGL C.112, S.12E = Minor Consent to Care, Drug Dependency, Liability f/Payment
APPENDIX B: LAW AND POLICY AROUND HEALTH AND HEALTH EDUCATION
Following is a summary of selected significant Massachusetts and federal laws and state policies that address health education, student health services, and health-related protection for students.
Instruction and Curriculum
- Health Education
Health education is one of the subjects addressed under Massachusetts General Laws (MGL) Chapter 71, Section 1. In relevant part, this statute provides:
Instruction in health education shall include, but not be limited to: consumer health, ecology, community health, body structure and function, safety, nutrition, fitness and body dynamics, dental health, emotional development, and training in the administration of first aid, including cardiopulmonary resuscitation. In connection with physiology and hygiene, instruction as to the effects of alcoholic drinks and of stimulants, including tobacco, and narcotics on the human system, as to tuberculosis and its prevention, as to detection and prevention of breast and uterine cancer, and as to fire safety, including instruction in the flammable qualities of certain fabrics, and as to the prevention and treatment of burn injuries, shall be given to all pupils in all schools under public control, except school maintained solely for instruction in particular subject areas.
No pupil shall be required to take or participate in instruction on disease, its symptoms, development and treatment, whose parent or guardian shall object thereto in writing on the grounds such instruction conflicts with his sincerely held religious beliefs, and no pupil so exempt shall be penalized by reason of such exemption. Such other subjects as the school committee considers expedient may be taught in the public schools.
- Physical Education
MGL Chapter 71, Section 3 states:
Physical education shall be taught as a required subject in all grades for all students in the public schools for the purpose of promoting the physical well being of students. Instruction in physical education may include calisthenics, gymnastics and military drill; but no pupil shall be required to take part in any military exercise if his parent or guardian is of any religious denomination conscientiously opposed, and the school committee is so notified in writing; and no pupil shall be required to take part in physical education exercises if a licensed physician certifies in writing that in his opinion such physical education exercise would be injurious to the pupil.
- Academic Standards
MGL Chapter 69, Section 1D directs the Board and Commissioner of Education to develop academic standards for the core subjects of science, technology and mathematics, history and social science, English, foreign languages and the arts. This statute includes the following provision:
The standards may provide for instruction in the issues of nutrition, physical education, AIDS education, violence prevention, and drug, alcohol and tobacco abuse prevention. The board may also include the teaching of family life skills, financial management and consumer skills,
- Grant Programs for Comprehensive Interdisciplinary Health Education and Human Services
MGL Chapter 69, Section 1L authorizes the Board of Education to establish a comprehensive interdisciplinary health education and human service discretionary grant program, subject to appropriation. This statute describes in detail the components of such programs.
- Board of Education Policy on HIV/AIDS Education
In 1990, the Board of Education issued a policy statement on HIV/AIDS education. In part, it states:
AIDS (acquired immune deficiency syndrome) and infection with HIV (human immunodeficiency virus), the virus that causes AIDS, are serious threats to the lives and health of young people in Massachusetts. Therefore, the Board of Education of the Commonwealth of Massachusetts urges local school districts to create programs which make instruction about AIDS/HIV available to every Massachusetts student at every grade level. These programs should be developed in a manner which respects local control over education and involves parents and representatives of the community. The Board believes that AIDS/HIV prevention education is most effective when integrated into a comprehensive health education and human services program.
Parental Involvement and Notification
- Sexuality Education; Parental Notification
MGL Chapter 71, Section 32A, sometimes referred to as the Parental Notification Law, states:
Every city, town, regional school district or vocational school district implementing or maintaining curriculum which primarily involves human sexual education or human sexuality issues shall adopt a policy ensuring parental/guardian notification. Such policy shall afford parents or guardians the flexibility to exempt their children from any portion of said curriculum through written notification to the school principal. No child so exempted shall be penalized by reason of such exemption.
Said policy shall be in writing, formally adopted by the school committee as a school district policy and distributed by September first, nineteen hundred and ninety-seven, and each year thereafter to each principal in the district. A copy of each school district's policy must be sent to the Department of Elementary and Secondary Education after adoption.
To the extent practicable, program instruction materials for said curricula shall be made reasonably accessible to parents, guardians, educators, school administrators, and others for review.
The Department of Elementary and Secondary Education shall promulgate regulations for adjudicatory proceedings to resolve any and all disputes arising under this section.
Federal law, known as the Protection of Pupil Rights Act, applies to programs funded through the U.S. Department of Education. The statute, 20 U.S.C. 1232h, includes the following provisions:
- All instructional materials, including teacher's manuals, films, tapes, or other supplementary material which will be used in connection with any survey, analysis, or evaluation as part of any applicable program shall be available for inspection by the parents or guardians of the children.
- No student shall be required, as part of any applicable program, to submit to a survey, analysis, or evaluation that reveals information concerning: (1) political affiliations; (2) mental and psychological problems potentially embarrassing to the student or his family; (3) sex behavior and attitudes; (4) illegal, anti-social, self-incriminating and demeaning behavior; (5) critical appraisals of other individuals with whom respondents have close family relationships; (6) legally recognized privileged or analogous relationships, such as those of lawyers, physicians and ministers; or (7) income (other than that required by law to determine eligibility for participation in a program or for receiving financial assistance under such program), without the prior consent of the student (if the student is an adult or emancipated minor) or in the case of an unemancipated minor, without the prior written consent of the parent or guardian.
MGL Chapter 69, Section 1C authorizes the Board of Education to establish minimum nutritional standards for school food services, and establishes the school lunch and school breakfast programs.
- Health Services and Related Issues
State law provides for the assignment of physicians and nurses to the public schools (MGL Chapter 71, Sections 53, 53A, 53B). MGL Chapter 71, Sections 54 and 57 address physical examinations for students. MGL Chapter 71, Section 54A requires assignment of medical personnel to interscholastic football games. MGL Chapter 71, Section 54B authorizes the Department of Public Health to regulate administration of medication to students in school settings.
- AIDS/HIV Prevention Education Policy Regarding Condom Availability In Schools
In 1990, the Board of Education issued the following policy statement:
Due to the rising rate of HIV infection and other sexually transmitted diseases among adolescents, the need to address infection prevention in all ways possible is critical at this time. In Massachusetts, decisions about AIDS/HIV prevention education and sexuality education, like all decisions about curriculum and educational policy, are made at the school district level. As school districts consider condom availability at the secondary level, the Board of Education makes the following recommendations as an addendum to the AIDS/HIV Prevention Education Policy: We recommend that every school committee, in consultation with superintendents, administrators, faculty, parents and students, consider making condoms available in their secondary schools.
- Safety and Prevention of Injury and Violence
A number of state laws concern safety of students or of young people generally. For example, bicycle riders who are 12 years old or younger must wear a helmet while bicycling. MGL Chapter 85, Section 13A states:
Any person twelve years of age or younger operating a bicycle or being carried as a passenger on a bicycle on a public way, bike path or on any other public right-of-way must wear an approved helmet. Note: children under one year old must not be transported on a bike.
MGL Chapter 90, Section 7B (15) addresses instruction in bus safety:
All pupils transported in a school bus shall receive classroom instruction in safe riding practices at least three times during the following periods of each school year: the first week of the school year, the period between the months of September and January and the period between the month of January and the end of the school year. During each school year all such pupils shall participate at least twice in on-bus emergency evacuation drills.
MGL Chapter 71, Section 55C mandates that teachers and students must wear industrial quality eye protection during processes that may cause danger to the eyes.
MGL Chapter 71, Section 37H requires school districts to publish their policies concerning the conduct of teachers and students. The statute lists the elements that must be included in the code of discipline and the student handbook, including procedures assuring due process, standards and procedures for suspension and expulsion of students, and standards and procedures to assure school building security and safety of students and school personnel. MGL Chapter 71, Section 37H further authorizes the principal to expel "any student who is found on school premises or at school-sponsored or school-related events, including athletic games, in possession of a dangerous weapon, including but not limited to, a gun or knife; or a controlled substance as defined in chapter ninety-four C, including, but not limited to, marijuana, cocaine, and heroin," and to expel "any student who assaults a principal, assistant principal, teacher, teacher's aide or other educational staff on school premises or at school-sponsored or school-related events, including athletic games." MGL Chapter 71, Section 37H½ authorizes the principal to expel a student "upon being convicted of a felony or upon an adjudication or admission in court of guilt with respect to such a felony or felony delinquency," provided that the principal "determines that the student's continued presence in school would have a substantial detrimental effect on the general welfare of the school."
MGL Chapter 71, Section 37L requires school personnel to take certain steps, including notifying police and the Department of Social Services, if a student possesses or uses a dangerous weapon on school grounds. MGL Chapter 269, Section 10 prohibits the carrying of loaded or unloaded firearms on school grounds without specific authorization. The Federal Gun-Free Schools Act requires school districts to expel from school for not less than one year any student who has brought a firearm to school.
MGL Chapter 269, Sections 17, 18 and 19 prohibit the crime of hazing and require schools to notify students and student groups of this prohibition.
- Child Abuse and Neglect
MGL Chapter 119, Section 51A requires teachers, health personnel, counselors, and other "mandated reporters" to report to the Department of Social Services if, in their professional capacity, they have "reasonable cause to believe that a child under the age of eighteen years is suffering physical or emotional injury" resulting from abuse, including sexual abuse, or from neglect. MGL Chapter 71, Section 37L requires school districts to inform all professional staff of their reporting responsibilities under the child abuse reporting law.
- Domestic and Dating Violence
Several laws may be implicated in teen dating violence situations. See generally: MGL Chapter 209A (restraining orders and abuse prevention); MGL Chapter 265 (crimes of assault; stalking; rape).
- Sex Offenders
MGL Chapter 6, Sections 178C-178O created a sex offender registry and established community notification regarding the presence of sex offenders. It is aimed at protecting children and others from dangerous recidivist sex offenders. As a matter of tort law, school districts have an obligation to protect employees and students from known or reasonably foreseeable and preventable dangers, including sexual assault by known pedophiles.
- Discrimination and Harassment
State and federal laws protect students against unlawful discrimination and harassment. See generally: MGL Chapter 76, Section 5 (prohibiting public schools from discriminating against students on the basis of race, color, sex, religion, national origin or sexual orientation); MGL Chapter 151C (fair educational practices); and the following Federal civil rights laws that protect students against discrimination in schools that receive federal funds: Title VI of the Civil Rights Act of 1964 (prohibiting discrimination against students based on race or national origin); Title IX of the Education Amendments of 1972 (prohibiting discrimination against students based on sex, including sexual harassment) and Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (prohibiting discrimination against students based on disability).
Several state laws address the possession or use of substances such as tobacco, alcohol, and drugs on school grounds. Two laws address tobacco use in schools. MGL Chapter 71, Section 37H states, in relevant part:
The superintendent of every school district shall publish the district's policies pertaining to the conduct of teachers and students. Said policies shall prohibit the use of any tobacco products within the school buildings, the school facilities or on the school grounds or on school buses by any individual, including school personnel. Copies of these policies shall be provided to any person upon request and without cost by the principal of every school within the district.
Further, MGL Chapter 71, Section 2A states:
It shall be unlawful for any student, enrolled in either primary or secondary public schools in the commonwealth, to use tobacco products of any type on school grounds during normal school hours.
Each school committee shall establish a policy dealing with students who violate this law. This policy may include, but not be limited to, mandatory education classes on the hazards of tobacco use.
With respect to controlled substances, MGL Chapter 71, Section 37H authorizes the principal of a public school to expel a student for use or possession of controlled substances, among other offenses. The statute states, in relevant part:
Any student who is found on school premises or at school-sponsored or school-related events, including athletic games, in possession of a dangerous weapon, including, but not limited to, a gun or a knife; or a controlled substance as defined in chapter ninety-four C, including, but not limited to, marijuana, cocaine, and heroin, may be subject to expulsion from the school or school district by the principal.
Additionally, MGL Chapter 94C, Section 32F (Unlawful manufacture, distribution, dispensing or possession with intent to manufacture, etc. of controlled substances in Classes A to C to minors) prohibits the distribution of controlled substances to a person under the age of eighteen.
With respect to alcohol on school premises, MGL Chapter 272, Section 40A states:
Whoever gives, sells, delivers or has in his possession any alcoholic beverage, except for medicinal purposes, in any public school building, or on any premises used for public school purposes and under the charge of a school committee or other public board or officer, shall be punished by imprisonment for not more than thirty days or by a fine of not more than one hundred dollars, or both; provided, however, that a school committee of a city, town or district may authorize a public or nonprofit organization using a public school building with its permission during non school hours to possess and sell alcoholic beverages therein provided such nonprofit organization is properly licensed under the provisions of section fourteen of chapter one hundred and thirty-eight.
Disease Prevention and Control
- Sick Children
Several laws protect students from exposure to disease. MGL Chapter 71, Section 55 concerns contagious diseases and school attendance. MGL Chapter 71, Section 55A concerns procedures for handling students who are sick, and also provides civil immunity to certain school employees who provide emergency first aid or emergency transportation to students. MGL Chapter 71, Section 56 concerns notice to parents when their children are sick.
MGL Chapter 71, Section 55B addresses tuberculosis tests for school employees. (See also MGL Chapter 69, Section 1C concerning Hepatitis B immunization for certain school employees.)
MGL Chapter 76, Sections 15 addresses immunization requirements for students. Unless exempted for religious reasons, no child may be admitted to school without proof of successful immunization against diphtheria, pertussis, tetanus, measles and polio and other communicable diseases determined by the Department of Public Health. (See also MGL Chapter 76, Sections15A and 15B concerning testing and screening students for sickle cell anemia.)
Confidentiality and Treatment
- Student Records
The Board of Education's Student Records Regulations, 603 Code of Massachusetts Regulations 23.00, address confidentiality of student records that are maintained by Massachusetts public elementary and secondary schools and by state-approved special education day and residential schools. The regulations provide detailed rules to insure parents' and students' rights of confidentiality, inspection, amendment, and destruction of student records. The state regulations are consistent with the Federal Family Educational Rights and Privacy Act, 20 U.S.C. sec. 1232g, and the FERPA regulations found at 34 CFR Part 99.
With respect to third party access to student records for health-related reasons, 603 CMR 23.07 (4) contains two relevant subsections:
- A school may disclose information regarding a student to appropriate parties in connection with a health or safety emergency if knowledge of the information is necessary to protect the health or safety of the student or other individuals. This includes, but is not limited to, disclosures to the local police department and the Department of Social Services under the provisions of M.G.L. c. 71, section 37L and M.G.L. c. 119, section 51A.
- School health personnel and local and state health department personnel shall have access to student health records, including but not limited to immunization records, when such access is required in the performance of official duties, without the consent of the eligible student or parent.
- Other Confidentiality Provisions
MGL Chapter 112, Section 129A provides for confidential communications between a licensed psychologist and the individuals with whom the psychologist engages in the practice of psychology. MGL Chapter 112, Section 135A provides for confidential communications between a licensed social worker and a client. Each of these statutes lists exceptions to the rule of confidential communications.
- AIDS/HIV Testing
MGL Chapter 111, Section 70F provides:
No health care facility, as defined in section seventy E, and no physician or health care provider shall (1) test any person for the presence of the HTLV-III antibody or antigen without first obtaining his written informed consent; (2) disclose the results of such test to any person other than the subject thereof without first obtaining the subject's written informed consent; or (3) identify the subject of such tests to any person without first obtaining the subject's written informed consent. No employer shall require HTLV-III antibody or antigen tests as a condition for employment. Whoever violates the provisions of this section shall be deemed to have violated section two of chapter ninety-three A. For the purpose of this section "written informed consent" shall mean a written consent form for each requested release of the results of an individual's HTLV-III antibody or antigen test, or for the release of medical records containing such information. Such written consent form shall state the purpose for which the information is being requested and shall be distinguished from written consent for the release of any other medical information, and for the purpose of this section "HTLV-III test" shall mean a licensed screening antibody test for the human T-cell lymphotrophic virus type III.
- Medical and Dental Care
MGL Chapter 112, Section 12F allows a minor to receive treatment without parental consent in special circumstances:
Any minor may give consent to his medical or dental care at the time such care is sought if (i) he is married, widowed, divorced; or (ii) he is the parent of a child, in which case he may also give consent to medical or dental care of the child; or (iii) he is a member of any of the armed forces; or (iv) she is pregnant or believes herself to be pregnant; or (v) he is living separate and apart from his parent or legal guardian, and is managing his own financial affairs; or (vi) he reasonably believes himself to be suffering from or to have come in contact with any disease defined as dangerous to the public health pursuant to section six of chapter one hundred and eleven; provided, however, that such minor may only consent to care which relates to the diagnosis or treatment of such disease. All information and records kept in connection with the medical or dental care of a minor who consents thereto in accordance with this section shall be confidential between the minor and the physician or dentist, and shall not be released except upon the written consent of the minor or a proper judicial order.
Another law addresses drug treatment. MGL Chapter 112, Section 12E states:
A minor twelve years of age or older who is found to be drug dependent by two or more physicians may give his consent to the furnishing of hospital and medical care related to the diagnosis or treatment of such drug dependency. Such consent shall not be subject to disaffirmance because of minority. The consent of the parent or legal guardian of such minor shall not be necessary to authorize hospital and medical care related to such drug dependency and, notwithstanding any provision of section fifty-four of chapter one hundred and twenty-three to the contrary, such parent or legal guardian shall not be liable for the payment of any care rendered pursuant to this section. Records shall be kept of such care. The provisions of this section shall not apply to methadone maintenance therapy.
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