Mandate: Code 7-401 of the Education Article, Annotated Code of Maryland (hereinafter referred to as 'Maryland Code') (1978) mandates that each county board of education, with the assistance of the county health department, shall establish a school health program that includes school health services, health education, and healthful school environments, including the importance of physical activity in maintaining good health. Health Education is also addressed in 2-205, 7-407, 7-409 (2005) and 7-411 of the Maryland Code.

State Board of Education Regulation 13A.04.18.01 (1990) mandates that students in grades K-8 shall receive instruction in comprehensive health education each year, although the amount of instruction is not specified. It also requires schools to offer comprehensive health education in grades 9-12. State Board of Education Regulation 13A.03.02.04 (1985) requires high school students to complete 1/2 credit of health coursework for graduation.

Curriculum Content: Required goals and sub-goals for a skills-based comprehensive health education program are detailed in State Board of Education Regulation 13A.04.18.02 (1994). Maryland also reports that it has a voluntary state curriculum for health education, which addresses content and will be included in the National Assessment Project.

HB9 (2012) encourages county boards of education to incporporate age-appropriate lessons on dating violence and diabetes and its treatment and prevention into the health education curriculum.

State Assessment Requirement: None.

Mandate: Codes 7-409 (2005) and 2-205 (1996) require each public school to have a physical education program for all students in grades K-12 to develop good health and physical fitness and improve motor coordination and physical skills.  State Board of Education Regulation 13A.04.13.01 (2001) outlines the requirements for the physical education instructional program in grades K-12. 

Code 7-409 (2009) directs the Department of Education to adopt regulations requiring public schools that are newly constructed or completely renovated after Jan 1, 2013 to include a gymnasium and adequate space for physical education instruction and to adopt guidelines for use of facilities for physical education programs.  

Code 7-4B-02 (2008) requires county boards of education develop policies and procedures to promote and protect the inclusion of students with disabilities into mainstream physical education and athletic programs.

Curriculum Content: Graduation requirements include one-half credit of physical education.  Regulation 13A.04.13.01 (2001) provides program goals for physical education in grades K-12.

Exemptions: None specified.

Physical Fitness Assessment: None.

State Board of Education Regulation 13A.04.18.01 requires mental and emotional health education as a part of the comprehensive health education.

Character Education: Not specifically required.

Mandate: State Board of Education Regulation 13A.04.18.01 requires the local school system to provide annual instruction in AIDS to all students at least once in grades 3—5, 6—8, and 9—12. The board will determine the three grades at which all students will receive instruction. It also requires instruction on human sexuality, with instruction of the objectives beginning in or prior to the fifth grade. Students must demonstrate " the ability to use human development knowledge, social skills, and health enhancing strategies to promote positive relationships and healthy growth and development throughout the lifecycle." In the area of disease prevention and control, students must  demonstrate the ability to apply prevention and treatment knowledge, skills, and strategies to reduce susceptibility and manage disease.

Curriculum Content: State Board of Education Regulation 13A.04.18.04 on HIV/AIDS prevention education lists several required topic areas and the content must be appropriate to the age, interests, and needs of students. The curriculum must be examined and reviewed for accuracy at least annually by an appointed committee comprised of educators, representatives of the community including parents/guardians of students enrolled in a public school program, and the local health department.

Parental Approval: The HIV/AIDS educational mandate, State Board of Education 13A.04.18.01, states that students may be excused from the instructional unit upon a written request from their parents/guardians (opt-out"). For students excused, the local school must provide apropriate learning activities in health education. When practical, curricular materials may be made available by the school system for home instruction use by parents/guardians of students excused from HIV/AIDS prevention instruction in the school. This regulation also requires that a committee comprised of educators, representatives of the community including parents/guardians, and the local health department examine all instructional materials.

State Board of Education Regulation ,13A.04.18.01 which describes the goals and subgoals of the required skills-based comprehensive health education program, does not require parental approval (opt-in") or to allow parents to remove students from class (opt-out").

State Board of Education Regulation 13A.04.18.01 requires notificaiton to parents announcing the human sexuality unit of study. Students may be excused from classes on family life and human sexuality upon a written request from their parents/guardians (opt-out). The regulation also requires the establishment of a joint committee of educators and representatives of the community for the purpose of reviewing and commenting on instructional material, to be submitted to the superintendent for consideration when recommending instructional material to be approved by the local Board of Education.

State Board of Education Regulation 13A.04.18.01 requires nutrition and fitness education as a part of the comprehensive health education.

Alcohol: State Board of Education Regulation 13A.04.18.02 (1991) requires that all students in grades K-12 acquire and apply knowledge of alcohol and the consequences of their non-use, use, and abuse, which includes the effects and interactions of alcohol, the physical, psychological, social, and legal consequences of the use of alcohol, skills to resist pressures to use alcohol, and prevention, intervention, and treatment services and resources.

Tobacco: State Board of Education Regulation 13A.04.18.02 requires that all students in grades K-12 acquire and apply knowledge of tobacco and the consequences of their non-use, use, and abuse, which includes the effects and interactions of tobacco, the physical, psychological, social, and legal consequences of the use of tobacco, skills to resist pressures to use tobacco, and prevention, intervention, and treatment services and resources.

Drugs: State Board of Education Regulation 13A.08.01.08 (2003) requires local boards of education to adopt policies on alcohol and drug use or possession, which include drug education curriculum. Regulation 13A.04.18.02 requires that all students in grades K-12 acquire and apply knowledge of drugs and the consequences of their non-use, use, and abuse, which includes the effects and interactions of drugs, the physical, psychological, social, and legal consequences of the use of drugs, skills to resist pressures to use drugs, and prevention, intervention, and treatment services and resources.

State Board of Education Regulation 13a.04.18.01 requires safety and injury prevention as a part of comprehensive health education.

Bullying/Harassment: Not specifically required but incorporated into health education and guidance lessons.

Dating Violence: HB845 (2009) requires the State Board to develop and implement a program in the schools to educate about dating violence. It requires a program to be started in each public school before the sixth grade.

Fighting/Gangs: The Safe Schools Act (2010) requires local school systems to develop educational programs in its efforts to address gangs, gang activity, and similar destructive or illegal behaviors. This program must include (1) an education and gang awareness program for students, staff, volunteers and parents and (2) a teacher and administrator development program that trains teachers and administrators to implement the policy or regulations.

Suicide and Other Self-Abuse Prevention: Not specifically required but incorporated into health education and guidance lessons.

Professional Development: Code 7-504 (1996) establishes standards and policies for the training of school personnel, and others responsible for counseling or supervising student activities, in suicide prevention to meet the requirement that all schools have Youth Suicide Prevention Programs.

State Board of Education Regulation 13A.08.01.08 (2003) requires local boards of education to adopt policies on alcohol and drug use or possession, which include staff training.

State Board of Education Regulation 13A.05.05.04 (1987) establishes the School Psychology Program, which may include staff development activities to help apply psychological principles to education.

Pre-service Requirement: The minimum requirement for prospective health teachers in elementary and middle grades prior to licensure is a bachelor's degree, with a major in an interdisciplinary or academic field. The specific details of initial licensure are outlined in State Board of Education Regulations 13A.12.02.04 (1994) and 13A.12.02.05 (1991). For prospective teachers, preK through 12th, a candidate is required to complete a bachelor's degree with a major in health, or complete a minimum of 36 semester hours of content course work in health, as outlined in State Board of Education Regulation 13A.12.02.18 (1989).

Professional Development: Regulation State Board of Education 13A.04.18.01 requires teachers of family life and human sexuality to have additional preparation in content and teaching methods of such depth and duration as to be appropriate for the material taught.

State Board of Education Regulation 13A.04.18.01 requires that "school staff selected to teach HIV/AIDS prevention curricular topics in the classroom shall receive in-service education before initiating instruction with students, and annually after that.

Pre-service Requirement: State Board of Education Regulation 13A.12.02.18 (2003) sets the minimum requirement for certification in physical education as possessing a bachelor's degree with a major in the physical education or completion of 36 semester hours of course content work in physical education and completing the professional education course and experience requirements found in State Board of Education Regulation 13A.12.02.06 (2003).

Professional Development: No state policy.

Pre-service Requirement: Code 8-302 (1995) requires the completion of an approved registered nursing program or an approved practical nursing program and the passing of the board approved licensing examination to be qualified as a registered nurse. In Maryland, the registered nurse (RN) is always the leader of the school health nursing team. The registered nurse (RN) makes the decisions about how care is provided and who provides the care to the child in the school system. As such, only the school registered nurse has the authority to use the title school nurse. All other health staff must be referred to by their title of licensed practical nurse (LPN), certified nursing assistant (CNA), or Health Assistant (health technician, etc.). 

Additional information on the definition of the role of the school nurse is available in the Maryland State School Health Guidelines Role of the Health Services Staff in Schools (2006).

The Maryland Board of Nursing requires School Health Nurses (public and nonpublic) to complete a Case Manager/Delegating Nurse training program. 

Professional Development: Maryland has no specific state policy for the professional development of school nurses. However, Code 7-504 (1996) establishes standards and policies for the training of school personnel, and others responsible for counseling or supervising student activities, in suicide prevention to meet the requirement that all schools have Youth Suicide Prevention Programs. Beginning in 2005, the Maryland Board of Nursing requires RNs in Assisted Living, Developmental Disabilities Administration, Juvenile services, and School Health (public and non-public) settings to complete a Case Manager/Delegating Nurse training program. The curriculum covers topics including, but not limited to: delegation requirements, principles of adult education, communication, and how to teach the updated medication technician training program. RNs who want to teach the medication technician training program must complete this curriculum. The Maryland Board of Nursing approved the 14 hour RN Case Manager/Delegating Nurse Training Program for School Health.

Student-to-Nurse Ratio: None specified.

Pre-service Requirement: The Maryland State School Health Guidelines, The Role of the School Nurse (2005), as well as the Maryland Nurse Practice Act, Regulations 10.27.11.03, 10.27.11.04 (2004), and 10.27.11.05 (1994) requires a registered nurse to determine delegation of nursing services with supervision over the individual performing the nursing function, as also mentioned in State Board of Education Regulation 13A.05.05.13 (1995). Certified Nursing Assistants in Schools Health Services Programs are required to take a 100-hour course, per Regulation 10.39.02.07, and be certified through the Board of Nursing. In addition, unlicensed personnel are required to take a 20-hour training specific to medication administration. Upon successful completion of the 20 hour medication administration training, the unlicensed personnel are certified by the Maryland Board of Nursing as a certified medication technician. Regulation 10.39.04.04 , 10.39.04.05, 10.39.04.06 outline these requirements.

State Board of Education Regulation 13A.05.05.08 (1995) requires the principal, in consultation with the designated health services professional, to identify school personnel who shall receive in-service training in providing recommended services for students with special needs.

Professional Development: State Board of Education Regulation 13A.05.05.09 (1991) requires at least one adult, other than the designated school health services professional and the school health services aide, to be certified in both the Red Cross' First Aid and CPR programs.

Pre-service Requirement: State Board of Education Regulation 13A.12.03.02 (2001) outlines four different options for requirement to be a school counselor in Maryland. All four options require a master's degree in school guidance and counseling, and three of the options require at least two years of satisfactory performance as a teacher or counselor. 

Professional Development: Maryland has no specific state policy for the professional development of school counselors. However, Code 7-504 (1996) establishes standards and policies for the training of school personnel, and others responsible for counseling or supervising student activities, in suicide prevention to meet the requirement that all schools have Youth Suicide Prevention Programs. 

Student-to-Counselor Ratio: No state policy.

Pre-service Requirement: State Board of Education Regulation 13A.12.03.08 (1989) requires potential school psychologists to meet the following experience and education requirements:

There are three options for meeting the education requirement and all require a qualifying score on the State-approved test for school psychology and either a graduate degree in psychology, education, or human development or a Nationally Certified School Psychologist certificate.

There are two options for meeting the experience requirement: (1) obtain 1,200 clock hours internship experience while enrolled in an institute of higher education's school psychology program or (2) have two years successful experience providing psychological services to children in an educational setting under the direction of a certified school psychologist. Both options require experiences in assessment, indirect and direct intervention, school/system support, and services to special and regular education students.

Professional Development: Maryland has no specific state policy for the professional development of school psychologists. However, Code 7-504 (1996) establishes standards and policies for the training of school personnel, and others responsible for counseling or supervising student activities, in suicide prevention.

Student-to-Psychologist Ratio: There is no state policy for employing a school psychologist. However, State Board of Education Regulation13A.05.05.04 (1987) establishes the School Psychology Program, suggests the need for a school psychologist to meet its required goals.

Pre-service Requirement: Code 6-704 (2004) requires both the State Board and the Board to develop rules and regulations for the certification of social workers employed by a local school. State Board of Education Regulation 13a.12.03.11 (2005) established certification requirements for school social workers.

Professional Development: Maryland has no specific state policy for the professional development of school social workers. However, Code 7-504 (1996) establishes standards and policies for the training of school personnel, and others responsible for counseling or supervising student activities, in suicide prevention.

Student-to-Social Worker Ratio: No state policy.

Pre-service Requirement: No state policy.

Professional Development: No state policy.

Pre-service Requirement: State Board of Education Regulation 13A.06.03.04 (1964) only allows schools to employ only teachers or certificated professional educator employees of the local board as coaches. Temporary coaches may be hired if no acceptable and qualified coaches are available if the procedures outlined in the Regulation are followed.

Professional Development:  State Board of Education Regulation 13A.06.03.04 (1964) requires all coaches to have completed or be enrolled in a one-credit prevention and care of athletic injuries course.

Additional Accountability Requirements: HB1264 (2009) authorizes local school systems to develop and implement annual wellness policy implementation and monitoring plans. It also requires the Department of Education to develop a procedure to monitor and measure implementation of a local school system's wellness policy monitoring implementation plan, and provide technical assistance to support local systems in this effort. Requirements for local school systems' plans are outlined in the statute.

Additional Content Requirements: None

Guidance Materials: The Department of Education provides guidance for wellness policy monitoring and implementation in Making Wellness Work: A Guide to Implementing and Monitoring Wellness Policies in Maryland (2009)

Other: None

Food Services: Code 7-601 requires that State Board of Education to adopt and publish standards for the administration of the subsidized and free feeding program, including eligibility conditions and a requirement that each county board provide a reduced price lunch program. Code 7-603 requires public schools to offer a program of subsidized or free feeding for eligible children. Code 7-701 requires elementary schools to offer a free and reduced-price breakfast program if the percentage of enrolled students eligible for free or reduced-price meals is 15% or greater. Code 7-704 authorizes the Maryland Meals for Achievement classroom breakfast program, which provides meals at no cost to all children in participating schools. To be eligible, at least 40% of enrolled students in a school must be eligible for free or reduced-price meals.

Department of Education Management and Operations Memorandum (MOM) 012 (2005) limits the sale of beverages at all schools during the school day to the following:  water, non-carbonated, flavored water with less than 20 calories per serving, unflavored milk or soy milk (no more than 30gms/serving of sugar per 8 ounce serving), 100% fruit/vegetable juice (not to exceed 12 ounces), fruit/vegetable juice beverages with at least 10% juice and 100% vitamin C (not to exceed 12 ounces), isotonic beverages (not to exceed 16 ounces).

Adequate Time to Eat: No state policy.

School Breakfast: Code 7-701 (1999) and 7-702 (1999) requires school breakfast in public elementary schools. Schools with less than 15 percent free and reduced lunch eligible students may be exempted.

Food Allergies: HB26 (2009) requires the principal of a public school which has a student attending the school that has been identified to the school as having an anaphylactic allergy must designate a peanut-and tree nut-free table in the cafeteria.

Farm-to-School: SB 158 (2008) establishes a farm-to-school program in the Department of Agriculture. The program is established to do the following: (1) Promote the sale of farm products grown in state to Maryland schools, (2) Solicit farmers to sell their products to schools, (3) Develop and update a database of interested farmers and their products, (4) Facilitate purchases from farmers by interested schools, (5) Provide outreach and guidance to farmers, and (5) Organize a one week promotional event known as "Maryland Homegrown School Lunch Week." 

Vending Machines/School Stores:  Code 7-423 requires vending machines in public schools to have and use a timing device to automatically prohibit or allow access to vending machines in accordance with the nutrition policies established by the respective county school board.

Department of Education Management and Operations Memorandum (MOM) 012 (2005) limits the sale of beverages at all schools during the school day to the following:  water, non-carbonated, flavored water with less than 20 calories per serving, unflavored milk or soy milk (no more than 30gms/serving of sugar per 8 ounce serving), 100% fruit/vegetable juice (not to exceed 12 ounces), fruit/vegetable juice beverages with at least 10% juice and 100% vitamin C (not to exceed 12 ounces), isotonic beverages (not to exceed 16 ounces).

Other Food Sales:  Department of Education Management and Operations Memorandum (MOM) 012 (2005) prohibits the sale of Foods of Minimal Nutritional Value (FMNV) as defined in Appendix A of the memorandum, from 12:01 am until the end of the last lunch period for all schools.

Department of Education Management and Operations Memorandum (MOM) 012 (2005) recommends that all other food" (including pre-packaged snacks) served in elementary and middle schools outside of the Child Nutrition Program should be offered only in single-serving portions.  The unit sold, regardless of the number of portions in the package, should contain:

• No more than 9 grams of total fat, excluding seeds and nuts
• No more than 2 grams of saturated fat
• No more than 15 grams of sugar, excluding dried fruit with no added sugar.

School Gardening: No state policy.

General Physical Activity Requirement: No state policy.

Recess or Physical Activity Breaks: No state policy requiring or recommending recess.

Recess Before Lunch: The State Department of Education includes providing recess before lunch as a sample goal in its guidance document for wellness policy implmentation and monitoring, Making Wellness Work: A Guide to Implementing and Montoring Welness Policies in Maryland  (2009).

Walking/Biking to School: No state policy.

Interscholastic Athletics: State Board of Education Regulation 13A.06.03.02 (1994) sets the eligibility requirements for student participation in interscholastic athletics at the high school level.

Concussion and Sports-Related Head Inury:  SB 771 defines concussion, student athlete, and youth recreational sports program, and requires the Departments of Education and Health, county boards of education, Maryland Public Secondary Schools Athletic Association, Maryland Athletic Trainers Association and the Brain Injury Association of Maryland to develop policies and implement a concussion program to provide awareness to coaches, school personnel, student athletes and parents and guardians of student athletes. The program must include the following:

• The nature and risk of a concussion and head injury
• Criteria for removal from and return to play
• Risk of not reporting injury and continuing to play
• Appropriate academic accommodations for student athetes suspected of sustaining a concussion or other head injury
• A process to verify that coaches have received information about the concussion program

County school boards must provide student athletes with information about concussions and head-injuries prior to participation in an athletic activity. Student athletes and their parents or guardians must sign a statement acknowledging receipt. Student athletes suspected of sustaining a concussion or any other head injury at a practice or game must be removed from play and may not return until they have received written clearance from a licensed health care provider trained in the evaluation and management of concussions and head injuries.

Automated External Defibrillator (AED): Code 7-425 (2006) requires each county board to develop an AED program for each high school in the county. The program must ensure that an AED is provided on site and an individual trained in the operation and use of an AED is present at all school-sponsored athletic events.

State Board of Education Regulation 13A.01.04.03 (2003) states that, “All students in Maryland's public schools, without exception and regardless of race, ethnicity, region, religion, gender, sexual orientation, language, socioeconomic status, age, or disability, have the right to educational environments that are safe, appropriate for academic achievement, and free from any form of harassment”.

Code §7-424 (2005) local boards of education to submit an annual report to the Department of Education citing incidents of harassment or intimidation against students in public schools. The Department is also required to create and distribute standard victim of harassment and intimidation report forms. 

State Board of Education Regulations 13A.08.01.18, 13A.08.01.19, 13A.08.01.20 (2003) define a ‘persistently dangerous’ school as a school in which each year for a period of three consecutive school years, the total number of student suspensions for more than 10 days or expulsions equals two and one-half percent or more of the total number of students enrolled in the school, for any of the following offenses: Arson or fire; Drugs; Explosives; Firearms; Other guns; Other weapons; Physical attack on a student; Physical attack on a school system employee or other adult; and Sexual assault. Students enrolled in such schools are allowed to transfer to another, safe school within the same district.

Education Code §7-304.1 mandates that local boards of education require elementary schools that have a suspension rate that exceeds 18% of the school’s enrollment to implement a Positive Behavioral Interventions and Supports (PBIS) Program or an alternative behavioral modification program in collaboration with the Maryland State Department of Education.

The Safe Schools Act (2010) allows a local superintendant and school principal to consider prohibiting a student who is arrested for a reportable offense involving rape or a reportable offense from attending the same school or riding the same bus, if such an act is necessary to protect the victim. If a student is convicted or adjudicated delinquent for a rape or sexual offense, the student may not attend the same school or ride on the same bus as the student.

The Safe Schools Act (2010) requires each school that enrolls students in grades 6-12 to designate at least one school security officer.

Fighting/Gangs:   The Safe Schools Act (2010) requires State Board of Education and Department of Education to develop a model policy to address gangs, gang activity, and similar destructive or illegal group behaviors in schools.  The resulting policy is Maryland's Model Policy to Address Gangs, Gang Activity, and Similar Destructive or Illegal Behavior (2011). The model policy is to be used by local districts to develop their own policies to address gangs, gang activity, and similar destructive or illegal group behavior in schools. 

Safe Schools Act (2010) requires school employees to report any incidents of suspected gang activity or similar destructive or illegal group behavior promptly to the principal and security officer (if one is present). It also requires each county superintendent to require regular school security meetings for each middle school and high school to ensure coordination of gang prevention, intervention and supression.

Code §7-307 (1996) gives authority to a principal, teacher, school security guard or other school personnel to take reasonable action to prevent violence on school premises which includes intervening in a fight or physical struggle.

Weapons: State Board of Education Regulation 13A.08.01.12-1 (2003) provides minimum guidelines for discipline for firearm possession on school property or at a school-sponsored activity. The offending student is to be expelled for a minimum of one year, except in the case of a student with a disability, in which case the student may either be suspended or expelled.

Drugs and Alcohol: State Board of Education Regulation 13A.08.01.08 (2003) prohibits students from possessing or using alcohol or other drugs on school premises. Local boards of education are also required to adopt policies on alcohol and other drug use or possession as stipulated within this regulation.

Collaboration with Law Enforcement: State Board of Education Regulation 13A.08.01.12-1 requires instances of firearms possession on school property or at school sponsored events to be reported to the appropriate juvenile justice or criminal enforcement agency.

State Board of Education Regulation 13A.08.01.08 requires local boards of education to coordinate efforts with local law enforcement to prevent alcohol and drug abuse, detect possession of alcohol and illegal drugs by students on school premises, report and investigate activity related to alcohol and other drug abuse on school premises, and seize and store contraband.

State Board of Education Regulation 13A.08.01.14 (1997) requires schools to comply and cooperate with police searches when a warrant is issued. Police officers shall conduct searches of students and the school premises in accordance with their established policies and procedures.

State Board of Education Regulation 13A.08.01.17 (1994) requires the local superintendent or designee, when notified that a student has been arrested for a reportable offense, to notify that student’s school principal of the arrest and the pertinent information, including the charges. Further, unless ordered otherwise by a juvenile court or other court, the reportable arrest information is confidential and may not be re-disclosed or made part of the student’s permanent educational record.

Bullying/Harassment: State Board of Education Regulation 13A.01.04.03 (2003) states that, “All students in Maryland's public schools, without exception and regardless of race, ethnicity, region, religion, gender, sexual orientation, language, socioeconomic status, age, or disability, have the right to educational environments that are safe, appropriate for academic achievement, and free from any form of harassment”.

Code§7-424 (2008) defines bullying, harassment and intimidation, including electronic bullying, and requires local boards of education to submit an annual report to the Department of Education citing incidents of bullying, harassment or intimidation against students in public schools. An incident may be reported by a staff member, student, or the parent, guardian or close adult relative of a student. The Department is also required to create and distribute standard victim of bullying, harassment and intimidation report forms. The requirements for these forms are outlined in the statute. The Department of Education is then required to submit an annual summary of the reports to the Senate.

Code §7-424.1 (2008) requires the State Board to develop a model poicy prohibiting bullying, harassment, or intimidation in schools. The model policy shall include the following: (1) A statement prohibiting bullying, harassment, and intimidation in schools; (2) A statement prohibiting reprisal or retaliation against individuals who report acts, (3) A definition of bullying, harassment, or intimidation that is either the same as set forth in Code §7-424 (2008) or another definition not less inclusive, (4) Standared consequences and remidial actions for persons committing acts, for persons engaged in reprisal or retaliation, and for persons ound to have made false accusaions; (5) Model procedures for reporting and investigation of acts; and (6) Information about support services for bullies, victims and bystanders and about the use of the reporting form.

Code §7-424.1 (2008) also requires each County Board shall establish a policy prohibiting bullying, harassment, or intimidation at school based on the model policy. Specific requirements of the policy are outlined in the Code. The policy must be published in student hanbooks, school system websites and other appropriate locations. Each County Board is required to develop, in conjunction with the policy, an educational program for students, staff, volunteers and parents, and a training program for teachers and administrators for policy implementation.

Cyberbullying: Code §7-424 (2008) includes an intentional electronic communication in its definition of bullying, harassment and intimidatdation and requires local boards of education to submit an annual report to the Department of Education citing incidents of bullying, harassment or intimidation against students in public schools. It defines "Electronic communication" as a communication transmitted by means of an electronic device, including a telephone, cellular phone, computer, or pager.  The policy each County Board is required to develop must include a definition of bullying and harassment the same or not less inclusive as that set forth in Code §7-424.1 (2008)

Hazing: Code 3-607 (2002) prohibits a person from recklessly or intentionally doing an act or create a situation that subjects a student to the risk of serious bodily injury for the purpose of an initiation into a student organization of a school, college or university.

Response and Management Plans: State Board of Education Regulations 13A.02.02.01, 13A.02.02.02, 13A.02.02.03, and 13A.02.02.04 require each local school system, in consultation with other health and safety officials, to develop an emergency plan for each public school and central office to deal with man-made, natural, and technological hazards. Each plan shall be on file and an annual schedule of drills for each school shall be developed and implemented.

Reporting Incidences of Violence: State Board of Education Regulation 13A.08.01.12-1 requires instances of firearms possession or violent crimes, as defined in this statute, on school property or at school sponsored events to be reported to the appropriate juvenile justice or criminal enforcement agency. HB 407 (2005) requires the State Department of Education to require local boards of education to report incidents of harassment or intimidation against students in public schools under the local board's jurisdiction. The Department is also required to create and distribute standard victim of harassment and intimidation report forms.

State Board of Education Regulations 13A.02.04.01, 13A.02.04.02, 13A.02.04.03, 13A.02.04.04, 13A.02.04.05, 13A.02.04.06, and 13A.02.04.07 (1992) prohibit the sale or use of tobacco in any form in school buildings at all times.  Additionally, the sale or use of tobacco in any form is prohibited on school grounds during the official school day.  The regulation requires each local school system to post notification to students, staff, and the general public that school buildings and grounds are tobacco free.  The regulations further required the Maryland State Department of Education to develop guidelines to assist local school systems in implementing a tobacco-free environment.  In addition to the Tobacco-Free School Environment, State Board of Education Regulation 13A.08.01.08 (2003) prohibits students from possessing or using tobacco in any form on school property.

Education Code 5-301 requires the State Board of Public Works to adopt regulations establishing criteria designed to enhance IAQ in relocatable (portable) school classrooms. Requires the regulations to include specifications for preventing mold/water damage, limiting infiltration of pollutants, providing continuous ventilation, and using low-emitting building materials.

Green Cleaning: HB1363 (2009) requires local boards of education to procure, to the extent practicably and economically feasible, green product cleaning supplies for use in schools. Green product cleaning supplies are defined as those that have positive environmental attributes, including biodegradability, low toxicity, low volatile organic compound content, reduced packaging, and low life cycle energy use.

Code 5-208.1 (2000) requires the Department of Agriculture to develop uniform standards and criteria for implementing integrated pest management systems in schools, so county boards may develop and implement the system in its schools. This uniform standard must include procedures of notifying parents and guardians and school staff, as well as provisions of written notification on an 8 X 11 size paper that contains the name of the pesticide, where it was applied, and emergency contact information. Similarly, Regulation 15.05.02.03 (2000) requires each county board of education to develop an integrated pest management policy, establish procedures for conducting the program, document and keep records of procedures, and educate and train staff members, students, and parents or guardians in the procedures. Further the regulation requires notification of a parent or guardian of a student attending the school and to staff members prior to the application of the pesticides in a school building or on school grounds.

No state policy.

Vision and Hearing: SB 600 (2008) requires each county board to provide hearing and vision screening for all students in the first year of school entry into the system and first grade, and eighth or ninth grade. Only those students whose parents object in writing to hearing and vision screening due to religious beliefs may be exempt. State Board of Education Regulation 13A.05.05.10 (no date available) requires a room shall be provided for hearing screening tests and space and lighting requirements for the specific vision test used shall be made available.

Chronic Health Conditions: Maryland does not specifically require schools or districts to identify students with asthma; however, Code 7-402 (1996) requires the Department of Education to adopt regulations requiring a physical examination for children entering the public school system for the first time. State Board of Education Regulation 13A.05.05.07 (1995) more specifically requires designated school health services personnel to conduct health appraisals to identify health problems and inform school personnel of conditions that may impede learning or require special care. Maryland State School Health Services Guidelines Management of Students with Asthma in School (2003), addresses how the needs of students with asthma should be addressed, planned for and documented.

Body Mass Index (BMI) Screening: No state policy.

Staff Administration: State Board of Education Regulation 13A.05.05.08 (1995) mandates local boards of education in conjunction with local health departments to develop policies ensuring school health services to be provided to all students with special health needs. The designated school health services professional can serve on the pupil services team and participate in the health services component of an Individualized Education Plan, the Individualized Family Service Plan, or the Transitional Plan committees.

SB 26 (2009) provides immunity from civil liability for an act or omission in the course of responding to an anaphylactic reaction of a child (except for any willful or grossly negligent act). 

Self-Administration of Asthma Medication: Code 7-421 (2005) requires schools to allow students to carry an asthma inhaler if an order is received by a physician and the school nurses reviews the student's technique. State Board of Education Regulation 13A.05.05.08 requires local boards of education, with the local health department, to formulate written policies regarding the administration of medication during school hours and school-sponsored activities.

Self-Administration of Anaphylactic Medication: Code 7-421 (2005) requires schools to allow students to self-administer an emergency medication if an order is received by a physician and the school nurses assess the student's technique. State Board of Education Regulation SB 26 (2009) requires the prinicipal of a public school in which a student has been identified as having an anaphylactic allergy to establish procedures for self-administration of medication by the student if he or she is determined to be capable of such administration. A school may revoke the authority of a child to self-administer if the child endangers himself or herself or another child through misuse.

Self-Administration of General Medication: The Maryland State School Health Services - Guidelines for the Administration of Medication in Schools addresses how the needs of students requiring medication should be addressed, planned for and documented. This document addresses self-administration of medication. A statewide medication form allows for a physician to order that a student may self-administer medication with the approval of the school nurse. 

Psychotropic Medications: No specific state policy. The Maryland State School Health Services - Guidelines for the Administration of Medication in Schools addresses how the needs of students requiring medication should be addressed, planned for and documented.

Storage and Record-keeping: State Board of Education Regulation 13A.05.05.08 requires local boards of education, with the local health department, to formulate written policies regarding the storage and administration of medication during school hours and school-sponsored activities. State Board of Education Regulation 13A.05.05.10 (1991) requires school buildings to make available locked file cabinets to use for storing health records and medications. The Maryland State School Health Services - Guidelines for the Administration of Medication in Schools addresses how the needs of students requiring medication should be addressed, planned for and documented, including storage and record keeping.

Medical Emergencies: State Board of Education Regulation 13A.05.05.09 (1991) requires a guide for emergency care management be developed and distributed by local health departments and boards of education to each school. Also, emergency information cards are to be maintained for each student and updated annually. Finally, emergency evacuation plans are required to be developed in consultation with the fire department, and shall include provisions for physically handicapped and other special health needs students.

State Board of Education Regulation 13A.05.05.08 requires the designated school health services professional to make a nursing care plan in case of emergency for individual students based on their special health needs. State Board of Education Regulation 13A.08.01.08 (2003) requires local boards of education to adopt policies on alcohol and other drug use or possession, including the provision of emergency medical care.

Requirement to Provide Services: State Board of Education Regulation 13A.05.05.01 (1989) requires each local school system to provide a coordinated program of pupil services, including guidance, school psychology, and health services. These services are also to include alternative and supplemental programs for students at risk. 

Code §7-401 (2005) requires each county board, with the assistance of the county health department, to provide adequate school health services. 

The school psychology program, per State Board of Education Regulation 13A.05.05.04 (1989), is to be a is to prevent or remediate educational, emotional, or behavioral problems by identifying, analyzing, and reporting psycho-educational needs through consultation, observation, or through psychological and educational assessment.

Identification Students with Mental or Emotional Disorders: Code 7-415 (1998) implements a health program in the underserved Caroline county, which concentrates on the early identification, health counseling, and referral for mental health problems to prevent suicides.

Substance Abuse: State Board of Education Regulation 13A.08.01.08 (2003) requires local boards of education to adopt policies on alcohol and other drug use or possession, including student referral procedures.

Suicide Prevention: Code 7-504 (1996) requires schools to establish a Youth Suicide Prevention Program, and includes standards for counseling, crisis intervention, and training of school personnel and others involved in counseling or supervising school activities. These programs are also to provide educational and/or training programs to address the issue of youth suicide through a variety of topics. Code 7-415 (1998) also implements a health program in the underserved Caroline county, which concentrates on the early identification, health counseling, and referral for mental health problems to prevent suicides.

HIV, STD, and Pregnancy Testing and Counseling: Maryland does not address testing, counseling, or condom availability programs. Code 7-401 delegates the authority for HIV, STD, and pregnancy testing and counseling to the local boards of education.

Immunity of Liability: No state policy.

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions:  Regulation 10.06.04.04 (no date available) allows for a medical exemption from immunization requirements if a licensed physician or health officer provides a written statement stating that the student's immunization against a disease listed in Regulation 10.06.04.03.  The physician or health officer must indicate whether the contraindication is permanent or temporary.  If it is temporary, the physician or health officer must provide a statement estimating when the immunization may be obtained by the student, and the student's parent or guardian must provide the school evidence of the completion of the immunization.   Regulation 10.06.04.05 (no date available) allows for a religious exemption from immunization requirements if a student's parent or guardian submits a form provided by the Department of Health and Mental Hygiene stating that they object to immunization on the grounds that it conflicts with their bona fide religious beliefs and practices.  This exemption does not apply, however, when the Secretary declares an emergency or epidemic of disease.

Maryland has no state law or administrative rule that addresses staff with HIV. However, Executive Order 01.01.1995.19: The Code of Fair Employment Practices (1995) addresses employment discrimination for those with HIV, not specific to a school setting.

No state policy. However, the State Department of Education has produced Guidelines for the Management of Students with HIV Infection in School (2002).

Maryland has no state law or administrative rule that addresses attendance for pregnant or parenting students. However, the state requires districts to offer alternative programs for such students under Regulation 13A.08.01.06 (1991) Educational Programs for Pregnant Girls.

Board of Education Regulation 13A.03.05.01 (1994) requires all school systems to comply with the federal Individuals with Disabilities Education Act and Section 504 of the Rehabilitation Act of 1973 when providing instructional services to public school students who are unable to participate in their school enrollment due to a physical or emotional condition. Board of Education Regulation 13A.05.05.08 (1991) allows a designated school health services personnel to participate in the health services component of the Individualized Education Plan, the Individualized Family Service Plan, or the Transitional Plan. This regulation also requires a student with special needs that may require particular attention during the school day to have a statement of those health needs and a nursing care plan for emergency and routine care prepared by the designated school health services professional.

State Level: In the 1950's the Maryland State School Health Council was established and formally reorganized in 1966. The council helps to develop and maintain programs that provide a healthful school environment, health and safety instruction, and school health services (Maryland Manual 1991-92). The group serves as an advisory board to the State Departments of Health, Education and the Governor's Office of Children, Youth, and Families. Members of the Executive Board meet with the Secretaries of each of these agencies annually. State Board of Education Regulation 13A.05.05.13 (1989) requires the Maryland State School Health Council to assist with the establishment of local school health councils.

Code 13-403 (1992) establishes the State Advisory Council on Physical Fitness. The purpose of this council is to protect and improve physical fitness along with other duties outlined in Code 13-407 (1993).

Local Level: State Board of Education Regulation 13A.05.05.13 requires the establishment of local school health councils under the joint responsibility of the local school superintendent and the local health officer.

State Level: No state policy.

Local Level: Education Code 7-401 (2006) requires each county board to designate a school health services program coordinator. A county board may authorize the county health department to designate this person. the school health services coordinator has the following responsibilities: (1) To implement state and local health policies in the public schools, (2) ensure that schools adhere to health service guidelines, and (3) communicate state and local health policies to parents and guardians of public school students. The Department of Education must conduct at least two meetings annually with all school health service program coordinators.

Student Health-Related Records: State Board of Education Regulation 13A.08.02.28 (1998) requires education and health records to be maintained and State Board of Education Regulation 13A.08.02.04 (1998) requires the confidentiality of the records, allowing access only to serve educational needs. 

Student Health-Related Services: The state does not have a policy specifically addressing the confidentiality of school health services. Code 20-102 (2001) does provide guidance for general medical treatment by allowing the attending physician, psychologist, or, on advice or direction of the attending health professional, a member of the medical staff to give a parent, guardian, or custodian of a minor or the spouse of the parent information about the treatment needed by or provided to the minor, except information about an abortion, but are not required to do so.

No state policy.