Mandate: The Missouri School Improvement Program, which includes school accreditation standards (2001), requires that elementary schools provide comprehensive health education that meets the state's academic standards. Junior high/middle schools must teach health (including tobacco, alcohol and other drug abuse prevention education, and HIV/AIDS prevention education) and safety education" for a minimum of 1,500 minutes each year. High schools must offer at least unit of health education out of 40.5 units. However, students are not required to complete a course in health education for high school graduation.

Curriculum Content: Revised Statute 160.514 (1993) requires the State Board of Education to develop academic standards and voluntary curriculum frameworks, and requires all schools to adopt or develop a written curriculum that meets the standards. 5 CSR 50-375.100 (1996) lists the Show-Me" academic standards for health and physical education. The state's voluntary framework is Missouri's Framework for Curriculum Development in Health Education and Physical Education (2009).

State Assessment Requirement: None.

Mandate: Revised Statute 161.102 (1995) requires the state board of education to adopt and implement rules and regulations for the provision of courses in physical education to all pupils and students in all public schools and in all educational institutions. The Missouri School Improvement Program, which includes school accreditation standards (2001), requires that each elementary student receives instruction in physical education for a minimum of 50 minutes each week (25 minutes for half-day kindergarten classes), and that the classes be taught by teachers certificated in the field. Junior high/middle schools must teach physical education to all students for a minimum of 3,000 minutes each year. High schools must offer at least 1 unit of physical education out of 40.5 units. Students must complete 1 unit credit in physical education, out of 24 specified units, for high school graduation as outlined in the Graduation Requirements Handbook  (2009).

Exemptions: None, except for students in the adult diploma program. On the contrary, the state's Graduation Requirements Handbook  (2009) specifies that, Courses devoted to conditioning for interscholastic sports or practicing for interscholastic sports may not be counted toward meeting the minimum requirement."

Curriculum Content: Revised Statute 160.514 (1993) requires the State Board of Education to develop academic standards and voluntary curriculum frameworks, and requires all schools to adopt or develop a written curriculum that meets the standards. 5 CSR 50-375.100 (1996) lists the Show-Me" standards for health and physical education. The state's voluntary framework is Missouri's Framework for Curriculum Development in Health Education and Physical Education (2009) which calls for students to receive instruction on efficiency of human movement and performance and on physical activity and lifetime wellness. 

Physical Fitness Assessment: Each year, schools are required to submit by building the percent of 5^th and 9^th grade students that meet the minimum criteria for the Missouri Physical Fitness Assessment Program (2000).

Missouri's Framework for Curriculum Development in Health Education and Physical Education (2009) calls for students in grades 5-8 to receive instruction on environmental impacts on health that can cause specific conditions such as asthma.

The Missouri Violence Prevention Curriculum Framework (2008) recommends that anger management be taught in schools.

Character Education: The  Missouri Violence Prevention Curriculum Framework (2008) recommends that character education be taught in schools; especially focusing on responsibility and respect.

Mandate: The Missouri School Improvement Program school accreditation standards (2001) requires schools offer comprehensive health instruction (including tobacco, alcohol and other drug abuse prevention education, and HIV/AIDS education). Junior high/middle schools must teach health (including tobacco, alcohol and other drug abuse prevention education, and HIV/AIDS prevention education) at the elementary, middle and high school levels.and safety.  Junior and high school students must receive a m inimum of1,500 minutes a year.High schools must offer at least unit of health education out of 40.5 units.

Curriculum Content: Revised Statute 170.015 (2007) requires any course materials and instruction relating to human sexuality and sexually transmitted diseases shall be medically and factually accurate and shall do the following: (1) Present abstinence from sexual activity as the preferred choice of behavior in relation to all sexual activity for unmarried pupils, (2) Stress that sexually transmitted diseases are serious, possible, health hazards of sexual activity. Pupils shall be provided with the latest medical information regarding exposure to HIV, AIDS, HPV, hepatitis and and other sexually transmitted diseases, (3) Present students with the latest medically factual information regarding both the possible side effects and health benefits of all forms of contraception, including the success and failure rates for the prevention of pregnancy and STDs; or present students with information on contraceptives and pregnancy in a manner consistent with the provisions of the federal abstinence education law, 42 U.S.C. Section 710, (4) Include a discussion of the possible emotional and psychological consequences of preadolescent and adolescent sexual activity and the consequences of adolescent pregnancy, as well as the advantages of adoption ,(5) Teach skills of conflict management, personal responsibility and positive self-esteem through discussion and role-playing at appropriate grade levels to emphasize that the pupil has the power to control personal behavior, (6) Advise pupils of the laws pertaining to their financial responsibility to children born in and out of wedlock and advise pupils of the provisions of chapter 566, RSMo, pertaining to statutory rape.

Missouri's Framework for Curriculum Development in Health Education and Physical Education (2009), which school districts are not required to follow, includes instructional guidelines for the prevention of HIV/AIDS, other STD's, and pregnancy at the high school level.

Parental Approval: Revised Statute 170.015 (1999) requires each school district to provide advance notice of course content and inform parents or guardians of their right to remove a student from human sexuality education (an opt-out" policy).

Missouri's Framework for Curriculum Development in Health Education and Physical Education  (2009) recommends that students receive instruction on food and nutrition as part of the health and enhancement section for grades K-12.

Alcohol: Missouri's school accreditation standards (2001) require that students at the elementary, middle, and high school levels are to receive instruction in comprehensive health including alcohol use prevention education. The topic is also featured in Missouri's Framework for Curriculum Development in Health Education and Physical Education (Healthy, Active Living K-12) (2003).

Tobacco: Missouri's school accreditation standards require that students at the elementary, middle, and high school levels are to receive instruction in comprehensive health including tobacco use prevention education. The topic is also featured in Missouri's Framework for Curriculum Development in Health Education and Physical Education (Healthy, Active Living K-12) (2003).

Drugs: Missouri's school accreditation standards require that students at the elementary, middle, and high school levels are to receive instruction in comprehensive health including drug use prevention education. The topic is also featured in Missouri's Framework for Curriculum Development in Health Education and Physical Education (Healthy, Active Living K-12) (2003).

Revised Statute 161.650 (2000) requires the Department of Elementary and Secondary Education to adopt an existing violent prevention program to be carried out by public school districts. This program shall include instruction on the negative consequences of membership or participation with criminal street gangs and shall include training for school district employees responsible for teaching violence prevention and intervention.  The Missouri Violence Prevention Curriculum Framework (2008) provides instructional guidance for schools implementing a violence prevention program.

Revised Statute 589.020 (1980) requires the department of elementary and secondary education to develop and establish sexual assault prevention and sexual assault counseling techniques and teaching guidelines for use by local school districts who choose to establish sexual assault prevention education programs.

Bullying/Harassment: The Missouri Violence Prevention Curriculum Framework (2008) recommends strategies to prevent students from becoming abusers of others by bullying and harassment.

Fighting/Gangs: The Missouri Violence Prevention Curriculum Framework (2008) recommends conflict resolution be taught in district schools and for the use of community resources, such as DARE officer, for gang awareness education in district schools. Rule 5 CSR 50-350.030 (1999) requires the department of elementary and secondary education to identify and, if necessary, adopt a program regarding violence prevention that includes instruction for students on the negative consequences of membership and/or participation in criminal gang activity.

Revised Statute 161.650 requires the department of elementary and secondary education to identify and adopt programs to be administered by public school districts regarding violence prevention. The program should include instructing students on the negative consequences of membership in or association with criminal street gangs or participation in a criminal street gang activity.

Revised Statute 170.046 (1995) requires the department of health and senior services, in consultation with the department of elementary and secondary education, to develop program materials known as School-Based Nonviolent Conflict Resolution" for use by school districts. The Statute allows the program to be presented to students in grades K-12 at least once each school year; however, academic credit cannot be received for participation in this program.

Suicide and Other Self-Abuse Prevention: The Missouri Violence Prevention Curriculum Framework (2008) recommends strategies to prevent students from becoming abusers of self through actions such as suicide.

Professional Development: No state policy specific to health education.

Revised Statute 160.261 (2004) requires all employees of the district to receive annual instruction related to the contents of the district's discipline policy including the approved methods of dealing with acts of school violence, disciplining students with disabilities and instruction and requirements for confidentiality. 5 CSR 50-350.030 (1999) also calls for the department of elementary and secondary education to identify and, if necessary, adopt a program regarding violence prevention that provides training for school district employees in violence prevention and early identification of and intervention in violent behavior.

Revised Statute 161.235 (2000) allows the 4-year competitive student suicide prevention programs to include teacher and administrator training for elementary and secondary schools.

Pre-service Requirement: The minimum requirement for prospective health teachers in elementary and middle grades is a bachelor's degree, with at least 21 credit hours in health. For prospective health teachers in high school, a bachelor's degree with at least 30 credit hours in health is required. 5 CSR 80-800.350 (2003) provides the general guidelines, while the Department of Education website provides further detail for the Missouri Educator Certification Requirements (2000).

Professional Development: Teachers with professional certification must partake in either 15 or 30 hours of professional development based on the number of years they have taught. A teacher may be exempt from this requirement if he/she meets two of the following: has 10 years of teaching experience, attains a higher degree, or attains national certification.

Pre-service Requirement: The state does not have a policy specifically stating pre-service physical educator requirements; however, Revised Statute 168.081 (2002) prohibits a person from engaging in the practice of teaching in grades K-12 without a valid Missouri certificate.

Professional Development: No state policy

Pre-service Requirement: No state policy.

Professional Development: The Missouri State Board of Nursing states that nurses have a responsibility to engage in on-going education and training. 

Student-to-Nurse Ratio: The Department of School Health Services funded programs are required to work toward or maintain a 750:1 ratio.

Pre-service Requirement: The Missouri State Board of Nursing, in their Utilization of Unlicensed Health Care Personnel, states that registered nurses may assign, delegate, and supervise specific nursing activities to unlicensed personnel. Registered professional nurses are required to adequately supervise and monitor the activities delegated and evaluate the unlicensed personnel's performance.

Revised Statute 167.621 (1993) prohibits any school employee from being required to administer medication or medical services for which he/she is not qualified.

Professional Development: The Missouri State Board of Nursing, in their Utilization of Unlicensed Health Care Personnel, states that registered nurses may teach unlicensed health care personnel in the performance of specific nursing care tasks.

Revised Statute 167.265 (1990) establishes a program to provide guidance counselors in grades K-9. Any public school containing these grades with a minimum enrollment of 125 students per school site, have a breakfast program, and serve at least 40% of its lunches to free and reduced price meals shall be eligible for a state financial supplement.

Pre-service Requirement: For certification as an elementary counselor for grades K-8 or a secondary counselor for grades 7-12, a candidate must possess a master's degree with a major emphasis in guidance and counseling from a department approved college or university, supervised practice for at least 3 semester hours, and knowledge and competency in the listed areas OR a candidate must have a master's degree or higher in school counseling or counseling or counseling psychology, additional graduate work in school counseling including a supervised internship of at least 300 hours.

Professional Development: Revised Statute 161.092 (2003), as reflected in standard 6.7 of the Missouri School Improvement Program (2001), recommends school districts provide substantial time and resources for professional development of all staff members. 

For renewal of an elementary counselor or secondary counselor certificate, a candidate must verify 2 years experience as a school counselor, document attendance at 3 professional workshops/seminars totaling 15 clock hours, and submit transcripts demonstrating at least 6 semester hours of graduate credit or verify 90 clock hours of professional workshops/in-services appropriate for elementary counselors.

Student-to-Counselor Ratio: The Missouri School Improvement Plan (2001) requires a 500:1 ratio for compliance with state accreditation standards.

Pre-service Requirement: For certification as a school psychologist, a candidate must have completed a specialist or equivalent degree with a major emphasis in school psychology from a department approved college or university, completed a minimum of 60 hours of graduate preparation with successful completion in the areas listed, demonstrated competencies in the 11 areas listed, completed a practicum experience and supervised internship, and achieved a minimum or greater qualifying score on the exit assessment.

Professional Development: Revised Statute 161.092 (2003), as reflected in standard 6.7 of the Missouri School Improvement Program (2001), recommends school districts provide substantial time and resources for professional development of all staff members. 

For renewal of a school psychologist certificate, a candidate must have verified 1 year experience as a school psychologist, documented at least 105 clock hours of professional workshops/seminars/conferences or submit transcripts showing graduate level school psychology coursework.

Student-to-Psychologist Ratio: No state policy.

Pre-service Requirement: No state policy.

Professional Development: Revised Statute 161.092 (2003), as reflected in standard 6.7 of the Missouri School Improvement Program (2001), recommends school districts provide substantial time and resources for professional development of all staff members.

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

Pre-service Requirement: No state policy.

Professional Development: No state policy.

Pre-service Requirement: Policies concerning athletic coaches are governed by the Missouri State High School Activities Association.

Professional Development: No state policy.

Additional Accountability Requirements: None

Additional Content Requirements: None

Guidance Materials: A Local Wellness Policy Presentation created by a Department of Education staff member includes resources, guidelines, requirements, etc to aid districts in developing local wellness policies. Also, the Missouri School Boards' Association has created numerous guidance documents, including a Model Wellness Policy, Model Wellness Procedure, and Model Implementation Evaluation Form.

Other: None

Food Services: Revised Statute 167.211 (1963) allows any school board to sell lunches to children attending the schools and shall not be sold at a price less than the cost of the food. 

State and local responsibilities for administering the Food Distribution Program can be found in 5 CSR 30-680.060 (1989), the National School Lunch Program found in 5 CSR 30-680.010 (1992), and the School Breakfast Program found in 5 CSR 30-680.030 (1993). 

Adequate Time to Eat:  No state policy.

School Breakfast: Statute 191.803 (2007) requires school boards to establish a school breakfast program in schools in which 35 percent or more of the students enrolled on October first of the preceding school year were eligible for free or reduced price meals.  

Food Allergies: HB922 (2009) 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 must contain the following elements: (1) Distinguish between building-wide, classroom, and individual approaches to allergy prevention and management;  (2) Provide age-appropriate response to building-level and classroom-level allergy education and prevention;  (3) Describe the role of both certificated and noncertificated school staff in determining how to manage an allergy problem,  (4) Describe the role of other students and parents in cooperating to prevent and mitigate allergies; (5) Address confidentiality issues involved with sharing medical information, (6) Coordinate with the school health advisory council, local health authorities, and other appropriate entities to ensure efficient promulgation of accurate information and to ensure that existing school safety and environmental policies do not conflict.

Farm-to-School: No state policy.

Vending Machines/School Stores: No state policy.

Other Food Sales: No state policy.

School Gardening: No state policy.

General Physical Activity Requirement: SB291 (2009) requires districts to ensure that elementary students participate in moderate physical activity for the entire school year, for an average of 150 minutes per five-day school week, or an average of 30 minutes per day. This also includes students in alternative education program. Students with disabilities shall participate in moderate physical activity to the extent appropriate as determined by the provisions of the Individuals with Disabilities Education Act, or Section 504 of the Rehabilitation Act. The statute does not require, but allows students in middle schools to participate in at least 225 minutes of physical activity per school week, at the schools. The elementary requirement may be met by additional physical education instruction, or by other activities approved by the individual school district under the direction of any certified teacher or administrator, or other school employee under their supervision.Interscholastic Athletics: No state policy.

Recess or Physical Activity Breaks: SB291 (2009) requires elementary schools to provide students a minimum of one recess period of twenty minutes per day. This may be incorporated into the lunch period.

Recess Before Lunch: No state policy.

Walking/Biking to School: No state policy.

Interscholastic Athletics: No state policy.

Concussion and Sports-Related Head Injury: Code 167.765 requires the department of health and senior services to work with various organizations (outlined in the statute) to promulgate rules which develop guidelines, pertinent information, and forms to educate coaches, youth athletes, and their parents and guardians of the nature and risk of concussion and brain injury including continuing to play after concussion or brain injury.  Each school district must annually distribute a concussion and brain injury information sheet to each youth athlete participating in the district’s athletic program. The sheet must be signed by their parent or guardian prior to participation in practice or competition. A youth who has been removed from play may not return to competition until they are evaluated by a licensed health care provider and given written clearance.

Code 167.775 requires any statewide athletic organization with public school membership to publish an annual report relating to the impact of concussions and head injuries on student athletes. The report must be distributed to a list of legislative committees outlined in the statute.

Automated External Defibrillator (AED): No state policy.

The Missouri School Improvement Program (MSIP) (2001) requires that schools are to be orderly and students and staff must feel safe at school. A written code of conduct should be put into place and enforced consistently. Revised Statute 161.650 (2000) requires the department of elementary and secondary education to identify and adopt programs to be administered by public school districts regarding violence prevention.

Regulation 5 CSR 50-355.100 (2000) states that a student should be allowed to attend a safe public school within the district if he/she is enrolled in a persistently dangerous school or becomes a victim of a criminal offense on school property.

Revised Statute 160.261  (2008) requires the local board of education of each school district to establish a written policy of discipline. A copy shall be provided to each student and parent or legal guardian. The policy shall require school administrators to report acts of violence to the appropriate law enforcement agency.

Revised Statute 160.261 (2008) gives authority to all school district personnel to hold every student strictly accountable for any disorderly conduct in school or on any property of the school, on any school bus going to or returning from school, during school-sponsored activities, or during intermission or recess periods. Revised Statute 167.161 (1997) allows the school district to suspend or expel a pupil for conduct that is does not promote good order or discipline or impairs the morale of good conduct of other pupils. Lastly, Revised Statute 563.061 (1979) allows the use of physical force by a teacher when he/she reasonably believes that the force was necessary to promote the welfare of the minor or to maintain reasonable discipline in a school, class or other group.

Fighting/Gangs: Revised Statute 565.075 (1996) classifies a person who knowingly causes physical injuryto another person or causes physical injury to another person with a deadly weapon or engages in behavior that puts a person at risk of death or a serious physical injury on school property as committing a crime of a assault class D felony.

Weapons: Revised Statute 160.261 (2008) requires school administrators to report acts of school violence which includes the possession of a weapon to teachers and other school personnel who are directly responsible for the student's education or interact with the student on a professional basis. Revised Statute 167.117 (2000) also requires the principal to immediately report to law enforcement officials and to the superintendent any instance of when a pupil has a weapon in his/her possession or placed elsewhere on school premises.

Revised Statute 160.261  (2008) requires the local board of education of each school district to establish a written policy of discipline. The policy must provide for a suspension period of not less than one year, or expulsion, for a student who is determined to have brought a weapon to school, including but not limited to the school playground, school parking lot, on a school bus or school activity, whether on or off school property.

Revised Statute 571.030 (2003) deems a person who discharges a firearm within 100 years of an occupied schoolhouse or someone who carries a firearm or any other weapon into any school, onto any school bus, or onto the premises of any function or activity sponsored or sanctioned by the school as committing the crime of unlawful use of weapons.

Drugs and Alcohol: Revised Statute 195.214 (2003) states that the distribution of a controlled substance near schools is a class A felony. Revised Statute 195.211 (2003) states that the distribution, manufacture, delivery, or production of a controlled substance within 2,000 feet of any school property is a felony.

Revised Statute 160.261 requires school administrators to report acts of school violence which includes the distribution of drugs to teachers and other school personnel who are directly responsible for the student's education or interact with the student on a professional basis. Revised Statute 161.504 (1990) allows the department of elementary and secondary education to allocate and award funds to local law enforcement agencies and public schools to jointly develop drug and alcohol use prevention and suppression programs.

Collaboration with Law Enforcement: The Missouri Violence Prevention Curriculum Framework (2008) recommends collaboration with local law enforcement, such as DARE officers, for developing and implementing the required violence prevention program. Revised Statute 161.504 allows the department of elementary and secondary education to allocate and award funds to local law enforcement agencies and public schools to jointly develop drug and alcohol use prevention and suppression programs.

Bullying/Harassment:Revised statute 160.775 (2009) requires every district to adopt an antibullying policy. Policies must treat students equally, not contain specific lists of protected classes who are to receive special treatment, and must contain a statement of the consequences of bullying. Each district's policy must require district employees to report any instances of bullying which the employee has first hand knowledge and must address training of employees.

Revised Statute 160.261 (2008) includes harassment as an "act of violence" that requires mandatory reporting by school administrators to the appropriate law enforcement agency. Harassment includes the following: (1) Knowingly communicating a threat to commit a felony to another person, thereby frightening, intimidating or causing emotional distress to such other person, (2) When communicating with another person, knowingly using coarse language offensively, thereby putting such person in reasonable apprehension of offensive physical contact or harm, (3) To knowingly frighten, intimidate or cause emotional distress to another person by anonymously making a telephone call or any electronic communication ("cyberbullying"), (4) Knowingly communicating with another person who is, or purports to be, seventeen years of age or younger, and in doing so recklessly frightening, intimidating or causes emotional distress, (5) Knowingly making repeated unwanted communication to another person, and (6) Engaging in any other act with the purpose to frighten, intimidate or emotionally distress another person.

Cyberbullying: Revised Statute 160.775 (2009) includes states that bullying may consist of physical actions, or oral, including cyberbullying, electronic, or written communication, and any threat of retaliation for reporting of such acts. The statute requires every district to adopt an anti-bullying policy. Revised Statute 160.261 (2008) includes harassment as an "act of violence" that requires mandatory reporting by school administrators to the appropriate law enforcement agency. This includes knowingly frightening, intimidating or causing emotional distress to another person by anonymously making a telephone call or any electronic communication ("cyberbullying").

Hazing: No state policy addressing elementary or secondary schools.

Response and Management Plans: The Missouri Violence Prevention Curriculum Framework (2008) recommends guidelines for crisis management and emergency response preparation plans. Revised Statute 160.480 (2004) authorizes local school boards to adopt an emergency preparedness plan regarding the use of school resources which includes school facilities, foods, school buses, and equipment if a natural disaster or other emergency occurs.

Reporting Incidences of Violence: Revised Statute 160.261 (2004) requires school administrators to report acts of school violence to teachers and other school personnel who are directly responsible for the student's education or interact with the student on a professional basis. The Revised Statute also requires school administrators to report to the appropriate law enforcement agency any of the felonies listed in the Statute, including the possession of a weapon. Similarly, Revised Statute 167.117 (2000) requires the principal to immediately report to law enforcement officials and to the superintendent any instance of assault in the 1^st, 2^nd, or 3^rd degree against a pupil or school employee, while on school property which includes a school bus that is servicing the district or while involved in school activities. Further, the principal is to report to the local law enforcement and to the superintendent any instances when a pupil has a weapon in his/her possession or placed elsewhere on school premises.

Revised Statute 191.775 (1993) prohibits the use of tobacco in any indoor area of a public elementary or secondary school building or on buses used to transport student to or from school. The school board may, however, set policies permitting the use of tobacco in non-classroom or non-student facilities, on school grounds or outdoor areas the school board considers appropriate.

Green Cleaning: Statute 161.365 (2008) requires the Department of Education, along with other stakeholders, to establish and amend on an annual basis guidelines and specifications for green cleaning programs, including environmentallysensitive cleaning and maintenance products, paper product purchases, and equipment purchases for cleaning programs. The Department must disseminate the resulting Green Cleaning Guidelines and Specifications for Schools (2009) to each district, which in turn must disseminate to each school.

No state policy.

Revised Statute 177.101 (1977) allows the school board to establish and maintain playgrounds for use of the public school district. The board may lease or purchase additional grounds for this purpose and must have full custody and control of the playground including policing and preservation.

Revised Statute 167.117 (2000) requires the principal to immediately report to law enforcement officials and to the superintendent any instance of when a pupil has a weapon in his/her possession or placed elsewhere on school premises including the school playground or parking lot.

Vision and Hearing: Revised Statute 167.194 (2007) requires every child enrolling in kindergarten or first grade in a public elementary school to receive one comprehensive vision exam performed by a licensed optometrist or physician by January 1 of the first year the child is enrolled in school. Schedules and protocols for screenings for school age children can be found in the Guidelines for Hearing Screening (2004), the Guidelines for Vision Screening (2004), and the Guidelines for Spinal Screening in Schools (2004).

Chronic Health Conditions: The state does not have a specific policy requiring schools to identify students with asthma. However, the Missouri School Improvement Program (MSIP) (2001) requires districts to have developed and implemented a school health services program which must include board-approved policies on procedures for monitoring students' with chronic health problems and develop strategies for addressing the problems to ensure academic progress.

Body Mass Index (BMI) Screening: Protocols for using BMI screening in schools can be found in the Guidelines For Growth Screening (2005).

Staff Administration: Revised Statute 167.621.1 (2002) requires parental authorization before providing health services including the administration of drugs or treatment. The statute does not require school employees to administer medication or medical services for which the employee is not qualified according to standard medical practices. The statute further protects school employees from any liability if procedures adopted by the local school board were followed. The Medication Guidelines provides further guidance regarding the administration of medications in schools. 

Revised Statute 167.630 (2006) allows each school board to authorize a licensed school nurse to maintain a stock of pre-filled epinephrine auto syringes.  It also authorizes a school nurse to administer an epinephrine auto syringe on any student believed to be having a life-threatening anaphylactic reaction.

The Missouri School Improvement Program (MSIP) (2001) requires districts to have developed and implemented a school health services program which must include board-approved policies on the administration of medication.

Self-Administration of Asthma Medication: Revised Statute 167.627.1 (2006) allows any board of education district to permit the self-administration of any medication prescribed or ordered by a physician for the treatment of asthma.  In order to obtain authorization, the student must present the following: (1) written authorization by the parents or guardians, (2) the student has demonstrated the skill level necessary to use the medication, (3) the student's physician has approved and signed a written treatment plan for managing asthma, and (4) the parent or guardian has signed a statement exempting the school district and its employees from liability as a result of any injury arising from the self-administration of medication.  Once authorization is granted, it permits a student to possess and self-administer asthma medication for one school year.  Students may self-administer medication while in school, at a school-sponsored activity, and in transit to or from school or a school-sponsored activity.

Self-Administration of Anaphylaxis Medication: Revised Statute 167.627.1 (2006) allows any board of education district to permit the self-administration of any medication prescribed or ordered by a physician for the treatment of anaphylaxis.  In order to obtain authorization, the student must present the following: (1) written authorization by the parents or guardians, (2) the student has demonstrated the skill level necessary to use the medication, (3) the student's physician has approved and signed a written treatment plan for managing asthma, and (4) the parent or guardian has signed a statement exempting the school district and its employees from liability as a result of any injury arising from the self-administration of medication.  Once authorization is granted, it permits a student to possess and self-administer anaphylaxis medication for one school year.  Students may self-administer medication while in school, at a school-sponsored activity, and in transit to or from school or a school-sponsored activity.

Psychotropic Medications: No state policy.

Storage and Record-keeping: No state policy.

Requirement to Provide Services: Rule 30-345.010 in section 6.9 of the Missouri School Improvement Program's Integrated Standards and Indicators Manual (2001) requires students have access to responsive services that assist them in addressing issues. The Missouri School Improvement Program (MSIP) (2001) determines guidance services as an integral part of the instructional program.

Identification of Students with Mental or Emotional Disorders: No state policy.

Substance Abuse: No state policy.

Suicide Prevention: Revised Statute 161.235 (2000) and 5 CSR 60-120.080 (2001) require the department of elementary and secondary education to adopt a 4-year competitive grant program that authorizes funds or subsidies for the establishment or expansion of a student suicide prevention program. 

HIV, STD, and Pregnancy Testing and Counseling: Missouri does not require or prohibit schools or districts to provide voluntary HIV, STD, or pregnancy testing or counseling services to students. However, Revised Statute 167.611 (1993) states, "contraceptive devices or contraceptive drugs shall not be provided by school personnel or their agents. When a child seeks contraceptive devices or contraceptive drugs, the child shall be referred to the previously designated family practitioner." In addition, parents must give written permission for a student to receive such a referral. 

Immunity of Liability: No state policy.

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  

Exemptions: 19 CSR 20-28.010 allows for medical exemption with certification by a doctor that either the immunization would danger the child's health or life or the child has documented immunity to the disease. Religious exemption is provided if the parent or guardian objects in writing to the school administrator that immunization of the child violates his/her religious believes.

 

No state policy. Missouri recommends that local school districts adopt policies such as those contained in its detailed Policy Guidance on Communicable Diseases (2006) document.

19 CSR 20-20.030 (2003) states that a person suffering from a reportable communicable disease, including AIDS, shall be barred from attending school unless readmitted by one of the following methods: 1) written certification of the person's non-infectiousness is provided by the attending physician; 2) after a period of time equal to the longest period of communicability of the disease; or 3) when local health authorities declare the health emergency ended.

Missouri recommends that local school districts adopt policies such as those contained in its detailed Policy Guidance on Communicable Diseases (2006) document.

Revised Statute 167.273 (1990) makes available additional state aid to local school districts for a program of parent education established in one or more high school that service pregnant teens and teen parents enrolled as pupils in the district. Revised Statute 167.270 (2002) encourages districts to offer alternative programs for pregnant or parenting students.

No specific policy. However, school districts must establish policies pertaining to 504-related health plans.

State Level: The Governor's Council on Physical Fitness and Health strives to promote a healthy Missouri where people are exercising regularly, eating nutritiously and making other healthy lifestyle choices."

Revised Statute 161.508 (1990) creates the state drug-free school advisory committee composed of governor appointed law enforcement officials, parents, administrators, and education and drug and alcohol professionals. 

Local Level: Revised Statute 167.611 (1993) allows a public school or district to establish an advisory committee composed of parents, teachers, health professionals, administrators, and students to revise and advise on the services to be provided to students in the school.

State Level: No state policy

Local Level: Revised Statute 168.171 (1963) allows school boards employing thirty or more teachers to employ a supervisor of physical education, a supervisor of health, and one or more school nurses to serve under the superintendent of schools of the district.

Revised Statute 160.660 (2000) requires each school district's safety coordinator to have thorough knowledge of federal, state, and local school violence prevention programs and resources and also requires the district to utilize the programs and resources that the board determines necessary and cost-effective for the district.

Student Health-Related Records: The Missouri School Improvement Program (MSIP) (2001) requires districts to have developed and implemented a school health services program which must include board-approved policies on the confidentiality of school health records.

Revised Statute 191.656 (2002) requires all information and records concerning an individuals HIV status or the results of HIV testing shall be kept strictly confidential and shall not be disclosed except to those listed in the Statute.

Student Health-Related Services: No state policy.

No specific state policy; Missouri adheres to federal PPRA requirements.