NJDOE Provides Guidance on the Requirement to Appoint a School Physician for the Provision of Health Services

On Wednesday, March 25, the New Jersey Department of Education (NJDOE) published the following broadcast memo providing guidance on the requirement to appoint a school physician for the provision of health services:

This New Jersey Department of Education (NJDOE) memo provides guidance to local school districts that may face challenges complying with the requirement that each district board of education, including charter school board of trustees, appoint at least one school physician.

The NJDOE understands the difficulties facing some local boards in appointing school physicians, amid health workforce personnel shortages, rising costs, complex insurance requirements, and other challenges. New Jersey statute (N.J.S.A. 18A:40-1) and New Jersey Department of Education (NJDOE) regulations (N.J.A.C. 6A:16-2.3(a)) establish the requirement for boards to appoint a school physician to provide critical health services such as consultation in the development and implementation of relevant school district policies, physical examinations for students who do not have a medical home, and written standing orders (N.J.A.C. 6A:16-2.3(a)4).

The NJDOE provides the following guidance on the role of school physicians and strategies the school districts may implement to sustain compliance with statutory and regulatory requirements pertinent to the role of the school physician:

To help minimize the risk of unexpected interruptions to student health services, districts are encouraged to review their school physician coverage and establish contingency plans where needed. Such plans may include agreements with neighboring districts, utilization of a team physician, or collaboration with a local health care system.

Districts should confirm that contractual agreements, standing orders and backup coverage arrangements are clearly defined and documented for impacted staff.

School physicians collaborate with local boards of education, district administrators and school staff to develop and implement policies, procedures and systems that promote student health and safety and support preparedness for, and response to, medical emergencies. They serve as a critical liaison among the medical home, the family, and the school. The school physician plays an essential role in supporting the day-to-day health care and educational needs of students, including those with complex or unique health conditions. Core roles and responsibilities of the school physician include, but are not limited to, the following:

• Developing, approving, and annually reviewing standing orders and protocols for routine illness and first aid, as well as for medical emergencies such as anaphylaxis, choking, and sudden cardiac events.
• Authorizing the district’s tuberculin testing program, as required by the New Jersey Department of Health (NJDOH).
• Establishing standing orders and protocols for the administration of epinephrine.
• Serving as a medical advisor for the district’s automated external defibrillator (AED) program, including oversight of medical protocols and training.

To support school physicians in fulfilling these responsibilities, the New Jersey Chapter of the American Academy of Pediatrics has established The New Jersey School Physician Coalition (NJSPC). The NJSPC is a statewide network of school physicians and key partners who collaborate to support student health and well-being.

The New Jersey Board of Nursing oversees nursing practice and ensures compliance with State law regarding nursing services. Registered nurses in New Jersey execute medical regimens prescribed by a licensed or otherwise legally authorized physician. School nurses work under the direction of the school physician through established standing orders and protocols.

Districts are encouraged to review all elements of their employment offerings, including provisions for professional liability insurance, and to evaluate advertising and hiring practices to attract qualified candidates. Additionally, districts may choose to pursue additional recruitment strategies that may include outreach to professional organizations such as the New Jersey Chapter of the American Academy of Pediatrics and the New Jersey Academy of Family Physicians. Local educational agencies may also consider contracting with local health care providers, including clinics or medical centers, or pursuing shared services agreements with neighboring districts.

Districts should ensure that school physician information in the New Jersey Statewide Longitudinal Education Data System (NJSLEDS) is up to date and should notify their local executive county superintendent if they experience difficulty securing or maintaining school physician services.

For additional questions, please email healthysch@doe.nj.gov.