Mandate: Health education is a required subject for Tennessee students in grades K-8 and Lifetime Wellness and Physical Education is a requirement for graduation per Rules of the State Board of Education, Minimum Requirements for the Approval of Public Schools 0520-1-3-.06 (2008).

Curriculum Content: The state board of education provides required curriculum standards: Health Education Standards Grades: pre K – 8 (2008) and Lifetime Wellness: Grades: 9 – 12 (2007), per Rules of the State Board of Education, Minimum Requirements for the Approval of Public Schools 0520-1-3-.05 (2008). 

The Tennessee State Board of Education Physical Activity Policy 4.206 (2005) requires, in subsequent years after 2006, that each LEA implement the Health Education Module of the Centers for Disease Control and Prevention’s (CDC) School Health Index (SHI) to plan and assess each school’s health education programs. 

State Assessment Requirement: None

Mandate: Physical education is a required subject for Tennessee students in grades K-8 and Lifetime Wellness and Physical Education is a requirement for graduation per Rules of the State Board of Education, Minimum Requirements for the Approval of Public Schools 0520-1-3-.06 (2008). Graduation requirements specify 1.5 credits of physical education and wellness. Code 49-6-1021 (2006) states, in accordance with 49-6-1022 (2006), it shall be the duty of each LEA to integrate a minimum of ninety (90) minutes of physical activity per week into the instructional school day for elementary and secondary school students. 

Exemptions: Rules of the State Board of Education, Minimum Requirements for the Approval of Public Schools 0520-1-3-.05 (2008) states that pupils who have physical disabilities shall have the Physical education and Lifetime Wellness program modified based on the annual written recommendation of a physician. The statement of the physician shall indicate the type of disability and include a recommended activity program. In addition, the rule permits school districts and schools to allow students to substitute JROTC for their required Lifetime Wellness credit in high school.

Code Ann.  49-6-1022 (2006) mandates the creation of a Physical Education Specialist position in the department of education.

Curriculum Content: Lifetime Wellness: Grades: 9 – 12 (2007) and Physical Education Grades 9-12 provide the required curriculum standards for health, physical fitness education and wellness in high school.

The Tennessee State Board of Education Physical Activity Policy 4.206 (2005) requires beginning July 1, 2006, that each LEA implement the Physical Education and Other Physical Activity Module of the CDC’s School Health Index to assess and plan each school’s physical activity.

Physical Fitness Assessment: Physical fitness assessment guidelines can be found at the Tennessee Department of Education web site Lifetime Wellness: Grades 9-12 (2007).

Not specifically required.

Health Education Standards Grades: pre K – 8 (2008) and Lifetime Wellness: Grades: 9 – 12 (2007) set standards for emotional, social and mental health education curricula, including teaching the characteristics of good mental health, coping skills, stress management, and how to develop and maintain a positive self-esteem. The Tennessee Model for Comprehensive School Counseling (2005) recommends standards and performance indicators for personal and social development education. Standard 7 recommends students in grades K-12 learn how to identify and express feelings and develop a positive self-attitude. Standard 8 recommends students in grades 6-12 learn problem-solving skills for anger and stress management and how to appraise personal skills that contribute to mental and physical health. Standard 9 recommends students in grades K-12 learn about stress and its effect on health and wellness, stress management and coping skills, and proper means of expressing anger. Students in grades 9-12 should also learn about the physical, emotional and psychological risks involved with sexual activity.

Character Education: Code Ann. § 49-6-1007 (2008) requires public school instruction to include character education to “help each student develop positive values and improve student conduct.” The department of education is required to provide the appropriate method of instruction for grades K-12, and LEAs may implement additional courses as they see fit.  This section is amended by 2008 Tenn. Pub. Acts 865 to urge public schools to include the use of nonviolence as a means of conflict resolution.

Mandate: Code §49-6-1008 (1989) states that the adoption of any AIDS education program shall be permissive and shall not be required until adopted by the LEA.  This law further requires that “all material which includes information pertaining to the prevention of acquired immune deficiency syndrome (AIDS) or other sexually transmitted diseases … shall place primary emphasis on abstinence from premarital intimacy and on the avoidance of drug abuse in controlling the spread of AIDS.”

In accordance with Code § 49-6-1301 (1989), “if the most recent, annual data maintained by the department of health, state center for health statistics, indicate that pregnancy rates in any county exceeded nineteen point five (19.5) pregnancies per one thousand (1,000) females aged fifteen (15) through seventeen (17), then every LEA within such county shall locally devise, adopt and implement a program of family life instruction in conformance with the curriculum guidelines established for such programs by the state board of education.”  

Curriculum Content: Code §49-6-1302 requires the state board of education to develop a complete family life instruction suitable for any local education agency which fails to devise, adopt and implement a local program pursuant to Code § 49-6-1301. Code § 49-6-1303 states that the the curriculum must exclusively  and  emphatically  promote  sexual  risk  avoidance through  abstinence,  regardless  of   a  student's  current  or   prior  sexual experience. In addition, it must: (1) Encourage  sexual  health  by  helping  students  understand  how sexual  activity  affects  the  whole  person  including  the  physical,  social, emotional,  psychological,  economic  and  educational  consequences  of   nonmarital sexual activity;  (2)  Teach  the  positive  results  of   avoiding  sexual  activity,  the  skills needed  to  make  healthy decisions,  the  advantages  of  and  skills  for   student success  in  pursuing  educational  and  life  goals,  (3) Provide factually and medically-accurate information;  (4) Teach  students how to form  pro-social  habits that enable students to  develop  healthy relationships,  create  strong  marriages,  and  form  safe  and stable future families; (5)  Encourage  students  to  communicate  with  a  parent,  guardian,  or  other  trusted adult about  sex or  other  risk behaviors; (6) Assist students in  learning and  practicing refusal skills that will help them resist sexual activity;  (7)  Address  the  benefits  of   raising  children  within  the  context  of   a marital  relationship  and  the  unique  challenges  that  single  teen  parents encounter; (8)  Discuss  the  interrelationship  between  teen  sexual  activity  and exposure  to  other  risk  behaviors  such  as  smoking,  underage  drinking,  drug use,  criminal activity, dating violence,  and sexual aggression; (9)  Educate  students  on  the  age  of   consent,  puberty,  pregnancy, childbirth,  sexually  transmitted  diseases,  and  the  financial  and  emotional responsibility of  raising a child; and (10) Teach students how to identify and form healthy relationships, and how to identify and avoid unhealthy relationships.

Per Code § 49-6-1304, the instruction of the curriculum may not promote,  implicitly  or   explicitly,  any  gateway  sexual  activity  or  health  message  that  encourages  students  to  experiment  with  non-coital sexual activity. "Gateway sexual activity" is defined as means sexual  contact encouraging an  individual to  engage in a non-abstinent behavior. It may not  (1) provide  or  distribute  materials  on  school  grounds  that  condone, encourage or  promote student sexual activity among unmarried students; (2)  Display  or   conduct  demonstrations  with  devices  specifically manufactured for  sexual stimulation; or  distribute  contraception  on  school  property;  provided,  however, medically-accurate  information  about  contraception  and  condoms  may  be provided so long as it is presented in a manner consistent with the other requirements and clearly informs students that only absinence removes all risk.  

Code § 49-6-1304 allows a parent or  legal guardian of  a student enrolled  in  family life may file a complaint with the director of  schools i f  the parent  or  legal  guardian  believes  that   a  teacher,  instructor,  or  representative  of  an organization  has  not  complied  with  the  requirements  of code Code § 49-6-1301 to 49-6-1304.

Tennessee State Board of Education, Standards and Guidelines for Tennessee’s Coordinated School Health Program 4.204 (2000) states that districts seeking funding for establishing a Comprehensive Health Education program must develop and maintain efforts in focusing on HIV/AIDS prevention education.

Tennessee State Board of Education, HIV/AIDS Policy for Employees and Students of Tennessee Public Schools 5.300 (2005) states that HIV prevention education is to promote healthful living and discourage the behaviors that put people at risk.

Parental Approval: Code § 49-6-1303 (1999) allows parents to request, in writing to the school’s principal, director of schools and board of education, that a student be exempt from family life instruction (an “opt-out” policy).

Standard 4 of the Health Education Standards Grades: pre K – 8 (2008) and Standard 3 Lifetime Wellness: Grades: 9 – 12 (2007) curriculum standards require nutrition education. 

Standards and Guidelines for Tennessee’s Coordinated School Health Program 4.204 (2000) states that districts seeking funding for establishing a Comprehensive Health Education program must develop and maintain efforts in focusing on healthy nutrition habits.A learning laboratory for nutrition and health education classes is provided to help students develop the skills of selecting nutritionally appropriate foods according to Standards and Guidelines for Tennessee’s Coordinated School Health Program 4.204.

Alcohol: The Health Education Standards Grades: pre K – 8 (2008) and Lifetime Wellness: Grades: 9 – 12 (2007) curriculum standards require substance use and abuse education. 

Tobacco: Health Education Standards Grades: pre K – 8 (2008) and Lifetime Wellness: Grades: 9 – 12 (2007) curriculum standards address substance use and abuse.  Standards and Guidelines for Tennessee’s Coordinated School Health Program 4.204 (2000) states that districts seeking funding for establishing a Comprehensive Health Education program must develop and maintain efforts in focusing on tobacco use and cessation in its comprehensive K-12 health education.   

Drugs:  The Health Education Standards Grades: pre K – 8 (2008) and Lifetime Wellness: Grades: 9 – 12 (2007) curriculum standards require substance use and abuse education.

Code 49-1-220 (2006) urges the department of education to develop a sexual violence awareness curriculum for presentation at least once in grades 7 and 8, and once, preferably twice, in grades 9-12.  The curriculum should include instruction to increase students' awareness and understanding of teen dating violence and sexual violence, including, but not limited to, date, acquaintance, and stranger rape and statutory rape, rape prevention strategies, resources and support available to victims of teen dating violence and sexual violence, and prosecution of crimes associated with teen dating and sexual violence.

Bullying/Harassment:  Standard 9 of the Tennessee Model for Comprehensive School Counseling (2005) addresses acquiring personal safety skills.  Students learn the consequences of bullying and harassment in grades 3-5 and techniques for handling overt and subtle bullying and harassment in grades 9-12. 

Fighting/Gangs:  Lifetime Wellness: Grades: 9 – 12 (2007) requires students identify positive ways of resolving interpersonal conflict by practicing non-abusive behavior.  Standard 9 of the Tennessee Model for Comprehensive School Counseling (2005) addresses acquiring personal safety skills.  Students learn to recognize physical and sexual abuse in grades 3-5 and conflict management and the emotional effects of abuse in grades 6-8.

Suicide and Other Self-Abuse: Lifetime Wellness: Grades 9-12 (2000) requires students learn to recognize the signs of a potential suicide and how to identify resources for suicide prevention. Standard 9 of the School Counseling & Career Guidance Standards recommends students in grades 6-8 learn how to recognize the indicators of depression and suicidal and homicidal tendencies.

Sexual Violence:  Code 49-1-220 (2006) urges the department of education to develop a sexual violence awareness curriculum for presentation at least once in grades 7 and 8, and once, preferably twice, in grades 9-12.  The curriculum should include instruction to increase students’ awareness and understanding of teen dating violence and sexual violence, including, but not limited to, date, acquaintance, and stranger rape and statutory rape, rape prevention strategies, resources and support available to victims of teen dating violence and sexual violence, and prosecution of crimes associated with teen dating and sexual violence. 

Professional Development: Code §49-6-4302 (1999) calls for the establishment of a Tennessee school safety center by the department of education to develop and evaluate training materials and guidelines on school safety issues for employees.

The Tennessee State Board of Education, HIV/AIDS Policy for Employees and Students of Tennessee Public Schools 5.300 (2005) requires each LEAs Director of Schools to provide all employees with current HIV training. 

Pre-service Requirement: The minimum requirement for prospective health teachers is a bachelor’s degree, with a health-related content major.  The specific details of initial licensure are outline in the Tennessee Licensure Standards and Induction Guidelines (2005). 

Professional Development:  The state does not fund programs for staff development specific to the topics of HIV, STD, and/or teen pregnancy prevention; however, staff development programs on HIV are provided and funded through the state’s cooperative agreement with the CDC.

Pre-service requirement:  A prospective physical educator must have a minimum of a bachelor’s degree, a supervised physical education internship or student teaching experience in both K-4 and 5-12 settings, and a major in physical education.  Further specifics are outline in the Tennessee Licensure Standards and Induction Guidelines (2005).  Tennessee State Board of Education, Standards and Guidelines for Tennessee’s Coordinated School Health Program 4.204 (2000) specifically states that physical education teachers and physical activity specialists provide for physical education and related fitness activities.

Professional Development: None specified.

Pre-service Requirement: The Guidelines for Use of Health Care Professionals and Health Care Procedures in a School Setting (2007) define a school nurse as someone who is professionally educated as a registered nurse and whose role is to strengthen and facilitate the educational process by improving and protecting the health status of students. For licensure as a registered nurse, Rules of the Tennessee Board of Nursing (2007) requires the completion of an approved school of professional nursing and the passing of a board-approved examination.

Professional Development: Continuing education for re-licensure is not mandatory in Tennessee.  However, mandatory continuing competency is required in Tennessee.  In order to maintain continued competence, the board requires the nurse to have practiced in nursing in the last five (5) years and additionally, the Board sets out standards of competence and requirements to maintain competence.  See Rules of the Tennessee Board of Nursing 1000-1-.14 and 1000-2-.14 (2007).

Student-to-Nurse Ratio: Code § 49-3-359 (2004) provides funding to public school systems for school nurses at the ratio of one per 3,000 students or one per school system, whichever is greater, and allows school systems to employ school nurses or contract them through the Public School Nurse program established in Tenn. Code Ann. § 68-1-1201 (1988).

Pre-service Requirement: Code § 49-5-415 (2006) allows public and nonpublic school boards to permit an employee or person under contract to the board to assist in the self-administration of medications.

Professional Development: Code § 49-5-415 (2006) allows school personnel who volunteer, and who have been properly trained by a registered nurse or contracted by the LEA, may administer glucagons in emergency situations to a student based on that student’s individual health plan (IHP).  Code § 68-140-510 (1983) is not specific to school settings, it does allow the department of health to approve and coordinate a training course in the administration of epinephrine injections for lay individuals 18 years of age or over in emergency situations.

Pre-service Requirement: Tennessee Licensure Standards and Induction Guidelines (2005) requires prospective school counselors to have a minimum of a graduate degree and approved preparation in school guidance and counseling, the recommendation of the guidance and counseling program’s institution, a supervised internship lasting the equivalent of at least one semester, and a semester long teaching orientation experience in a school setting. Further details on licensure are found within this policy.

Professional Development: None specified.

Student-to-Counselor Ratio: Code § 49-6-303 (1999) requires schools to employ school counselors in grades pre-kindergarten through twelve (pre-K-12) in order to provide preventative and developmental counseling.

Pre-service Requirement: Tennessee Licensure Standards and Induction Guidelines (2005) requires prospective school psychologists to have a minimum of a graduate degree in school psychology from a program approved by the National Association of School Psychologists, supervised field experiences, a supervised internship equal to one academic year of full-time work, half in a school setting and half working with children, youth, and families. Further details on licensure are found within this policy.

Professional Development: None specified. 

Student-to-Psychologist Ratio: None specified.

Pre-service Requirement: Tennessee Licensure Standards and Induction Guidelines (2005) requires prospective school social workers to have a minimum of a bachelor’s degree in social work from a program accredited by the Council on Social Work Education and have the joint recommendation of the college/department of education and the college/department of social work. Further details on licensure are found within this policy.

Professional Development: None specified. 

Student-to-Social Worker Ratio: None specified.

Pre-service Requirement: None specified.

Professional Development: None specified.

Pre-service Requirement: None specified.

Professional Development: None specified.

Additional Accountability Requirements: The Tennessee State Board of Education Physical Activity Policy 4.206 (2005) requires each school district’s School Health Advisory Council to annually administer CDC’s SHI: A Self-Assessment and Planning Guide and report a summary to the state.  In addition, the State Board also adopted a rule for Rules of the State Board of Education, Minimum Nutritional Standards for Individual Food Items Sold or Offered for Sale to Pupils in Grades Pre-Kindergarten through Eight (pre-K-8) 0520-1-6-.04 (2008).

Additional Content Requirements: The State Board of Education adopted a rule for Minimal Nutritional Standards for Items Sold or Offered for Sale during the School Day in Grades K-8 (2005) that includes specifications for allowable foods. 

Guidance Materials: None

Other: None

 Food Services:  The Rules of the State Board of Education, Minimum Nutritional Standards for Individual Food Items Sold or Offered for Sale to Pupils in Grades Pre-Kindergarten through Eight (Pre-K-8) 0520-1-6-.04 (2008) require the following minimum nutrition standards for individual foods items offered for sale to students in grades pre-k-8, anywhere on campus, during the school day. The standards do not apply to federally reimbursable meals, although it is strongly recommended. 

• Beverages may only include milk (flavored or unflavored, reduced-fat, low-fat or skim/non-fat), 100% fruit and vegetable juices, (non-flavored, non-sweetened and non-carbonated) water, low-calorie beverages (flavored, sweetened and non-caffeinated) containing no additional sweeteners and no more than 15 calories/serving.
• Food items must have 35% or less calories from fat (excluding nuts, seeds and nut butters), 10% or less calories from saturated fat, and 35% or less sugars by weight (not including fruits and vegetables).
• Chips, cereals, crackers, French fries, baked goods, and other snack items may contain no more than 230 mg of sodium/serving; pastas, meats and soups may contain no more than 480 mg/serving.

Adequate Time to Eat: No state policy.

School Breakfast: Code 49-6-2302 (1986) requires school breakfast in K-8 schools in which 25 percent or more students participated in the free and reduced price lunch program,  based on a cumulative analysis of school lunch participation for the month of April of the preceding school year. For those schools not containing grades K-8, a breakfast program is required when 40 percent or more of students participated in the free and reduced price lunch program.

Food Allergies: Code 49-5-415 (2006) mandates the Departments of Education and Health to develop and make available guidelines for the management of students with life-threatening food allergies to each local education association (LEA). Upon issuance of the guidelines, each LEA is required to implement a plan based on the guidelines. Code 49-5-415 (2006) requires that guidelines include the following: (1) Education and training for school personnel on the management of students with life-threatening food allergies, (2) Procedures for responding to life-threatening allergic reactions to food, (3) Record  maintenance for students at risk, (4) Communication strategies for emergency medical response, (5) Strategies to reduce the risk of exposure to anaphylactic causative agents, (6) Procedures for the dissemination of information on life threatening food allergies and for accessibility of and administration of epinephrine in the absence of a school nurse, (7) Development of extracurricular programs related to anaphylaxis, (8) Creation of an individualized health plan for each student at risk and (9) Data collection. The resulting Guidelines for Life-Threatening Food Allergies in Tennessee Schools (2007) provide detailed instruction for LEAs in the development of food allergy management in the schools.

Chapter 963 of the Public Acts of 2008 amends subdivision (6) of Code § 49-6-2307 (2008) to include language that encompasses the availability of local agricultural products when establishing minimum nutritional standards for school lunch and school breakfast programs. 

Farm-to-School: Chapter 963 of the Public Acts of 2008 amends subdivision (6) Code § 49-6-2307  (2008) to include language that encompasses the availability of local agricultural products when establishing minimum nutritional standards for school lunch and school breakfast programs. 

Vending Machines/School Stores: Restrictions outlined in Rules of the State Board of Education, Minimum Nutritional Standards for Individual Food Items Sold or Offered for Sale to Pupils in Grades Pre-Kindergarten through Eight (Pre-K-8) 0520-1-6-.04 (2008) (see above) foods and beverages sold in school stores, fund raisers, a la carte, vending machines, snack bars, etc.

Other Food Sales: See Vending Machines/School Stores.

School Gardening: No state policy.

General Physical Activity Requirement: 49-6-1021 (2006) requires each local education agency to integrate a minimum of 90 minutes of physical activity per week into the instructional school day for elementary and secondary school students.  Opportunities to engage in physical activity may include walking, jumping rope, playing volleyball, or other forms of physical activities that promote fitness and well being. 

The Tennessee State Board of Education Physical Activity Policy 4.206 (2005) requires that each LEA implement the Physical Education and Other Physical Activity Programs Module of the CDC’s SHI to assess the school’s learning environment.

Recess or Physical Activity Breaks: Although not specifically requiring recess, 49-6-1021 (2006) requires each local education agency to integrate a minimum of ninety minutes of physical activity per week into the instructional school day for elementary and secondary school students.  Opportunities to engage in physical activity may include walking, jumping rope, playing volleyball, or other forms of physical activities that promote fitness and well being. 

Recess Before Lunch: No state policy.

Walking/Biking to School: No state policy.

Interscholastic Athletics: Rules of the State Board of Education, Minimum Requirements for the Approval of Public Schools 0520-1-3-.05 (2008) states interscholastic athletics shall not be substituted for the wellness requirement.

Concussion and Sports-Related Head Injury: No state policy.
 
Automatic External Defibrillator (AED): Code 49-2-126 (2010) requires each local education agency to place an AED device in each school. AEDs must be placed in locations that are accessible during emergency situations and not in an office that is not accessible to any person who might need to use the AED or a location that is locked during times that students, parents or school employees are present at school or school events. Each LEA must annually review the efficacy of AEDs, ensure that they are placed in optimal locations and that all necessary training has been conducted.

Sports-Related Drug Testing: Code 49-6-4213 (2010)  allows a student to be subject to testing for the presence of drugs if there are reasonable indications to the principal that the student may have used or be under the influence of drugs. The need for such testing may be brought to the attention of the principal through a search authorized by §49-6-4204 or §49-6-4205, observed or reported use of drugs by the student on school property, or other reasonable information received from a teacher, staff member or other student. Standards for reasonableness outlined in the statute must be met to conduct the testing. The statute allows a student participating in voluntary extracurricular activities to be subject to random drug testing in the absence of individualized reasonable suspicion. Each LEA participating in the drug testing of students must develop policies and procedures to ensure that those students receive the assistance needed, including an assessment to determine the severity of the student's alcohol and drug problem and a recommendation for referral to intervention or treatment resources as appropriate. If an LEA adopts a policy permitting random drug testing of students in voluntary extracurricular activities, it must notify the parents and guardians that the student may be subjected to random drug testing prior to a student participating in an extracurricular activity, with the parent or guardian providing written consent. If a student is tested in a drug testing program and the results of the test are positive, all records of the test must be confidential. A student tested under a random drug testing program may not be suspended or expelled from school solely as the result of the positive test.

Code Ann. § 49-6-4216  (2000) requires LEAs to adopt written policies and procedures to ensure a safe and secure learning environment. Code Ann. § 49-6-3401 (2007) allows a principal, principal-teacher or assistant principal to suspend any pupil from attendance at a specific class, classes or school-sponsored activity without suspending such pupil from attendance at school pursuant to an in-school suspension policy adopted by the LEA. 

Code 49-6-(3-15) or the SAVE Act Schools Against Violence in Education) establishes specific and consistent requirements for local education agencies in providing a safe school environment. This includes developing a district-wide school safety plan and building-level school safety plans regarding crisis intervention, emergency response and emergency management. The act also establishes a state-level safety team to provide guidance to school districts in their efforts to address, plan, and implement an emergency response plan.        

Fighting/Gangs: Code 49-6-4215 (2008) allows local and county boards of education to promulgate and adopt rules and regulations to prohibit the activities of criminal gangs on school property. This includes the following: (1) Prohibiting students in grades 6-12 from wearing, while on school property, any clothing, apparel, or accessory which denotes membership or affiliation with any criminal gang, (2) Any activity that encourages participation in a criminal gang or facilitates illegal acts of a criminal gang, and (3) Any conduct that is seriously disruptive to the educational process or endangers persons or property. "Criminal gang" is defined in the statute.

Code 49-6-1027 (2008) requires each local education agency to annually evaluate the threat to and influence on students by gangs in the community. If the LEA finds that there is a substantial threat to or influence on students by gangs, then it must institute gang awareness education for elementary and middle school students and their parents in schools in neighborhoods with gang activity or the potential for gang activity.

Code 49-6-3401 (2007) allows students to be suspended for violence against another person attending or assigned to any public school. Code 49-6-3401 (2007) states that fights not involving the use of a weapon or does not result in serious injury to the involved parties shall only be reported to the school administrator. Code 49-6-4216 (2000) requires local and county boards of education to implement written policies and procedures to impose a zero-tolerance stance on students who assault teachers, students, or other persons while on school property, on a school bus, or at a school activity or event.

Weapons: 49-6-3401  (2007) allows students to be suspended for possession of a knife while on school property and requires a mandatory calendar year expulsion for any pupil determined to have brought to school, or to be in unauthorized possession on school property of, a firearm as defined in 18 U.S.C. § 921. Code 49-6-4216 (2000) requires local and county boards of education to implement written policies and procedures to impose a zero-tolerance stance on students who bring dangerous weapons onto school buses, school property, or to school events or activities.

Drugs and Alcohol: Code 49-6-3401 (2007) requires a mandatory calendar year expulsion for any pupil found in unlawful possession of drugs.

Code 49-6-4216  (2000) requires local and county boards of education to implement written policies and procedures to impose a zero-tolerance stance on drugs and drug paraphernalia.

Collaboration with Law Enforcement: Code 49-6-4302 (1999) also allows schools to partner with local law enforcement agencies to hire school resource officers. Code 49-6-3401 (2007) requires school principals with knowledge of an assault and battery committed by a student on school property must report said action to local law enforcement. Code 49-6-4215 (1994) requires local law enforcement agencies to advise the local school boards, upon request, of gangs which are associated with criminal activities.

Bullying/Harassment: Code 49-6-1015 (2005) defines harassment, intimidation or bullying in the school setting.  Codes 49-6-1016 (2009) and 49-6-1017 (2005) require each local agency to adopt a policy prohibiting harassment, intimidation or bullying.  Districts are required to include a definition of bullying, harassment, and intimidation, a statement prohibiting such acts, a description of the type of behavior constituting these acts, consequences and remedial action for harassment, intimidation, or bullying, and a procedure for reporting acts and conducting a prompt investigation.  Code 49-6-1018 (2005) prohibits retaliation or reprisal against a victim of or witness to or person with reliable information about an act of harassment, intimidation or bullying.   Code 49-6-1019 (2005) encourages school districts to form harassment, intimidation or bullying prevention task forces, programs, and other initiatives. Districts are encouraged to include a definition of bullying, harassment, and intimidation, a statement prohibiting such acts, a description of the type of behavior constituting these acts, consequences and remedial action for harassment, intimidation, or bullying, and a procedure for reporting acts and conducting a prompt investigation.

Cyberbullying: Although not specific to the school environment, under Code 39-17-308 (2009), threatening by electronic communication to take action known to be unlawful by any person is a Class A misdemeanor.

Hazing: Code 49-2-120 (2001) requires each school to adopt a written policy prohibiting hazing by any student or organization operating under school sanction.  The policy shall be distributed or made available to each student at the beginning of each school year.  During the first month of each new school year, time shall be set aside to specifically discuss the policy and its ramifications as a criminal offense and the penalties that may be imposed by the LEA.

Response and Management Plans: Code 49-6-804 (2007) requires each LEA to adopt a comprehensive district wide safety plan and building level school safety plan regarding crisis intervention, emergency response and emergency management.

Reporting Incidents of Violence: Code 49-6-4301 (2000) requires teachers who observe or have knowledge of an assault and battery committed by a student on school property must immediately report said action to the principal, who then must report to local law enforcement. Code 49-6-4209 (2007) requires school principals to report incidents or suspected incidents of illegal weapons possession on school grounds or within any school buildings or structure under the principal's supervision to the appropriate law enforcement officer. School personnel are required to report such incidents to the school principal, the designee, or the proper authorities if neither is available. Code 49-6-1016 (2005) also encourages districts to include in their policies a procedure for reporting acts of harassment, intimidation or bullying.

Code 39-17-1505 (2001) prohibits any person under the age of 18 to possess, purchase, or accept receipt a tobacco product. Furthermore, it is illegal to present or offer unto any person any false proof of age for the purpose of purchasing or receiving any tobacco product. Violation of this code is punishable by a fine between $10 and $50 and up to 50 hours of community service.

Code 39-17-1604 (2000) prohibits smoking in all public and private kindergarten, elementary and secondary schools. Adult staff members are, however, permitted to smoke outdoors, but not within 50 feet of any entrance into the building, and on school grounds after school hours, but not blocking any entrance to any building and not in any public seating area, bleachers for sporting events, or public restrooms. Additionally, Code 39-17-1803 (2007) prohibits smoking in enclosed school buildings. 

Code 49-2-121 (2005) encourages each school district to conduct an inspection and evaluation program for its facilities. Such program could be the Environmental Protection Agency's Indoor Air Quality Tools for Schools Program.

No state policy.

No state policy.

Guidelines for screening are outlined in the Tennessee School Health Screenings Guidelines Manual.

Vision and Hearing: Chapter 632 of the Public Acts of 2008 amends Code 49-6-5004 (2008) to state LEAs are encouraged to seek free or reduced-cost eye and/or hearing examinations.

Chronic Health Conditions: A health assessment by a registered nurse is advised for any child with acute or chronic health issues in the Tennessee State Board of Education, Guidelines for the Use of Healthcare Professionals and Health Procedures in a School Setting 4.205 (2007).

Body Mass Index (BMI) Screening: Code 49-6-1401 (2005) authorizes local education agencies (LEA) to implement programs that identify public school children who are at risk of obesity by training school volunteers and school staff in taking a BMI.   LEAs must complete a BMI-for-age for every child enrolled in the school system if not exempted by the parents. Schools must then provide each student's parents or guardians with a confidential health report card that represents the result of the child's BMI-for-age screening, along with basic educational information on what the results mean and what the parents or guardians should do with the information. Code 49-6-1402 (2005) mandates the department of education to provide a framework for a BMI screening program for LEAs. Code 49-6-1404 (2005) encourages schools with high rates of overweight children to expand or implement new school-based nutrition and physical activity programs.

Drug Screening: Code 49-6-4213 (2010)  allows a student to be subject to testing for the presence of drugs if there are reasonable indications to the principal that the student may have used or be under the influence of drugs. The need for such testing may be brought to the attention of the principal through a search authorized by §49-6-4204 or §49-6-4205, observed or reported use of drugs by the student on school property, or other reasonable information received from a teacher, staff member or other student. Standards for reasonableness outlined in the statute must be met to conduct the testing. The statute allows a student participating in voluntary extracurricular activities to be subject to random drug testing in the absence of individualized reasonable suspicion. Each LEA participating in the drug testing of students must develop policies and procedures to ensure that those students receive the assistance needed, including an assessment to determine the severity of the student's alcohol and drug problem and a recommendation for referral to intervention or treatment resources as appropriate. If an LEA adopts a policy permitting random drug testing of students in voluntary extracurricular activities, it must notify the parents and guardians that the student may be subjected to random drug testing prior to a student participating in an extracurricular activity, with the parent or guardian providing written consent. If a student is tested in a drug testing program and the results of the test are positive, all records of the test must be confidential. A student tested under a random drug testing program may not be suspended or expelled from school solely as the result of the positive test.

Staff Administration:  Code 49-5-415 (2011) states that a local education agency may permit an employee or person under contract to the board to assist in the self-administration of medication if the following conditions are met:  (1) employee providing assistance is a licensed health care professional, (2) the student is competent to administer medication with assistance, (3) the student’s medical condition is stable, (4) self-administration is documented, (5) guidelines for self-administration are followed and parental permission is granted and (6) assistance shall primarily include storage and timely distribution of medication.  Any person providing assistance under these conditions is not liable for injury resulting from “reasonable and prudent” assistance.

Code 49-5-415 (2011) provides for school nurses and other volunteer school personnel who receive appropriate training to assist with the care of students with diabetes.  Both school nurses and trained school personnel may administer Glucagon in emergency situations based on the student’s individual health plan (IHP).  However, if a nurse is available on site, they should provide the service to the student.  A school registered nurse and trained volunteer is not liable for injury resulting from “reasonable” assistance if it has been provided pursuant to the guidelines outlined in the statute.

Code 49-5-415 (2011) requires the department of education to provide guidelines for the management of students with life-threatening allergies. This includes training for school personnel for administration of a cartridge injector for life-threatening food allergies and procedures for school personnel to administer epinephrine when the school nurse is not available.

Code  49-5-415 (2011) requires the department of education to provide guidelines for the management of students with life-threatening allergies.  This includes training for school personnel for administration of a cartridge injector for life-threatening food allergies and procedures for school personnel to administer epinephrine when the school nurse is not available. 

Chapter 1054 of the Public Acts of 2008 amends Code 49-5-415 (2011) and states, “…[P]ublic and non-public school personnel who volunteer…and who have been properly trained by a registered nurse employed or contracted by the LEA…may administer anti-seizure medications, including diazepam gel, to a student in an emergency situation based on that student’s IHP.” 

Self-Administration of Asthma Medication:  Code 49-5-415 (2011) requires districts to permit possession and self-administration of a prescribed, metered dosage, asthma-reliever inhaler by an asthmatic student who provides the necessary authorizations from a parent and physician. Districts must inform parents and/or guardians in writing that the school and its employees are not liable as a result of any injury sustained by the student from self-administration. The parents are then required to sign the statement.  Procedural recommendations are further provided in the Tennessee State Board of Education, Guidelines for the Use of Healthcare Professionals and Health Procedures in a School Setting 4.205 (2007).

Self-Administration of Anaphylaxis Medication: Code 49-5-415 (2011) states that a student suffering from anaphylaxis is entitled to possess and self-administer prescription medication on school property or during a school event provided that written authorization is given by the parent, the parent exempts the school district and its employees from any liability, and a written statement outlining the circumstances in which the student shall self-administer and the name of the medication is given by the student’s physician.

Self-Administration of Diabetes Medication: Code 49-5-415 (2011) allows a student with diabetes to perform blood glucose checks, administer insulin, treat hypoglycemia and hyperglycemia, and otherwise attend to the care and management of the student’s diabetes in any area of the school or school grounds and at any school-related activity.  It also allows for the student to possess diabetes monitoring and treatment supplies, including sharps.  The student must have a medical management plan listing the health services needed that is signed by a parent or guardian and signed by a medical professional. 

Psychotropic Medications: Though not exclusively specified, Code 49-5-415 (2011) provides guidelines to assist with students who use medications.

Storage and Record-keeping: Code 49-5-415 (2011) allows a local education agency to permit an employee, or person under contract to the board, to assist in the self-administration of medications so long as the administration is properly documented and the medications are stored.

Requirement to Provide Services: Code 49-6-303 (1999) requires schools to employ school counselors in grades K-12 in order to provide preventative and developmental counseling.

The State Department of Education's Physical Activity Policy (2005) requires, beginning July 1, 2006, that each LEA implement the School Counseling, Psychological, and Social Services Module of the CDC's School Health Index to plan and assess each school's counseling and mental health services.

Identification of Students with Mental or Emotional Disorders: Code 49-6-303 (1999) requires school counselors to offer services related to the identification and placement of children with handicapping conditions and to implement an early identification and prevention program for potential attendance and retention problems. Code 49-6-6101 (1994) requires the state departments of education and mental health and mental retardation to take the listed actions to improve and coordinate services for behavioral emotionally disturbed children.

Substance Abuse: Code 49-6-4213 (2000) requires the principal or counselor of a school in which a student tested positive for drugs to provide referral information to said student and their parents or guardian, including inpatient, outpatient, and community-based drug and alcohol treatment.

Suicide Prevention: Code 49-6-3004 (2007) states the commissioner shall require that in-service training include at least two hours of suicide prevention education for all teachers and principals each school year.

HIV, STD, and Pregnancy Testing and Counseling: Code  68-34-107 (1971) allows contraceptive supplies and information be furnished by physicians to any minor who is pregnant, a parent, or married, or who has the consent of the minor's parent or legal guardian, or who has been referred for such service by another physician, a clergy member, a family planning clinic, a school or institution of higher learning, or any agency or instrumentality of this state or any subdivision of the state, or who requests and is in need of birth control procedures, supplies or information.

The Tennessee State Board of Education, HIV/AIDS Policy for Employees and Students of Tennessee Public Schools 5.300 (2005) requires students have access to voluntary counseling about matters related to HIV infection. School administrators must maintain a list of counseling and testing resources in the community and make it available for voluntary student use.

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: Code 49-6-5001 (2007) allows for medical exemption from immunization requirements if a qualified physician certifies that administration of immunizations would be in any manner harmful to the child.  49-6-5001 (2007) and 37-10-402 (1993) allow for exemption from immunization requirements if a parent or guardian files with proper authorities a signed, written statement that such immunization and preventive measures conflict with the religious tenets and practices of the parent or guardian affirmed under penalties of perjury.

The HIV-AIDS Policy for Employees and Students [SBE 5.300] (2005) outlines the rights and procedures of employees and students diagnosed with having HIV. The policy states, no school system employee diagnosed with HIV infection or AIDS shall be prevented from continuing employment based solely on this diagnosis." Review of employment conditions will be conducted by the superintendent, the employee's physician, and a physician or nurse from the Department of Health.

The Tennessee State Board of Education, HIV/AIDS Policy for Employees and Students of Tennessee Public Schools 5.300 (2005) outlines the rights and procedures of employees and students diagnosed with having HIV.  The policy allows students infected with HIV/AIDS to attend public school and participate in appropriate educational programs. The policy protects the student by prohibiting school systems from preventing an HIV-infected student from participating in educational or athletic programs on the basis of the diagnosis.

Tennessee attendance policies are the same for all students. Code  49-6-3002 (1990) requires education services to be provided to homebound or hospitalized students. The state does not require districts to offer alternative programs for such students as they are to be served in the regular program.

Code 49-5-415 (2006) requires registered nurses to complete an Individual Health Plan (IHP) for students with acute or chronic health issues that can serve as an asthma action plan. The Tennessee State Board of Education, Guidelines for the Use of Healthcare Professionals and Health Procedures in a School Setting 4.205 (2007) defines and details the requirements of the IHP.

Rules of the State Board of Education Special Education Programs and Services Chapter 0520-1-9-.06 (2008) requires an Individualized Education Program (IEP) to be developed for each child that has a disability and is in need of special education and related services. Chronic or acute health problems are included as an “other health impairment” disability in need of related services per Rules of the State Board of Education Special Education Programs and Services Chapter 0520-1-9-.02 (2008).

State-level:  Code 49-1-1001 – 1006 (2000) and is also known as Coordinated School Health Improvement Act of 2000 establishes Coordinated School Health in Tennessee. Code 49-6-1022 (2006) mandates the creation of a school health coordinator position in the department of education. 

Local-level: Schools or districts that receive funding under Code 49-1-1002 (2000) are required to have school health advisory councils, coordinating councils, and healthy school teams per state standards and guidelines. The Department of Education's Physical Activity Policy, SBE 4.206 (2005) requires each school health advisory council to serve as a resource for schools implementing health and nutritional policies, as outlined within this policy. 

State-level: Code 49-6-1022 (2006) mandates the creation of a school health coordinator position in the department of education.

Local-level: Codes 49-1-1002 and 49-6-1022 (2006) states each the LEA is authorized to implement a CSH program by the 2007-2008 school year.  As a part of this, districts are required to designate a school health program coordinator.

Student Health-Related Records: Code 10-7-504 (2007) requires all records, including any medical treatment, of students in public educational institutions to be treated as confidential.

The Tennessee State Board of Education, HIV/AIDS Policy for Employees and Students of Tennessee Public Schools 5.300 (2005) outlines confidentiality for employees.  HIV/AIDS information will remain strictly confidential. Permissible disclosure will occur pursuant only to signed authorization for release, appropriate court order or a lawfully issued subpoena. For students, HIV/AIDS information will remain strictly confidential. All medical information and written documentation of discussions, telephone conversations, proceedings, and meetings shall be kept by the superintendent in a locked file. If the HIV-infected student is under the age of 18, access to this file will be granted only to those persons with written consent of the infected student’s parent/guardian. Individuals will be informed of a student’s HIV infection on a need to know basis as decided by the evaluation team and with the written consent of the parent/guardian.

Student Health-Related Services: Code 68-34-107 (1971) allows contraceptive supplies and information to be furnished by physicians to any minor who has been referred for such service by a school or with consent of the parent or guardian.

Code 49-2-211 (1999) requires all LEA’s to have a policy stating “the rights of parents and students and guidelines for teachers and principals with respect to the administration of surveys, analyses, or evaluations of students”.