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City seeks clarification on school physicals

Posted: October 29, 2013 - 9:29pm

JUNEAU (AP) — School officials in Petersburg want clarification on a decades-old law their attorney reads as leaving districts responsible for the cost of school entrance physicals, an interpretation that could have financial implications for school districts statewide.

The issue was raised by parents, prompting Petersburg school officials to seek an attorney’s opinion. “He said, Yep, they’re right,” superintendent Robert Thomason said.

School officials believe they must follow the law but they also contend the law needs to be updated, he said. The original law dates to territorial days, 1953, and included a provision allowing for reimbursement by the state, up to $2.50 per student.

The law was updated in 1966, he said, and states that districts “shall provide for and require a physical examination of every child attending school in the district;” the only current reimbursement language refers to additional physical exams the state health department may require districts to provide.

Thomason said there are no committee records or minutes available to explain the rationale behind the change.

“If the legislature had wished to relieve school districts of the obligation to provide for the physical examinations it would likely have changed the language at that time,” he wrote in a legislative history of the law. “It did not.”

A state Department of Law spokeswoman was not aware of any attorney general’s opinions on the issue and said the agency had not been directly involved in the issue.

The Petersburg school district has requested help from local legislators and drafted a resolution for consideration at next month’s Association of Alaska School Boards’ gathering, urging a change in the law to make clear that districts aren’t required to bear the cost of the exams. The district also has asked the state health department for permission to have the school nurse provide the physicals at no cost to families. The law allows for exams to be done by a nurse if authorized by the state health commissioner or “if the services of a physician or chiropractor cannot be obtained.”

“We don’t want to be put in the position of knowingly not following the law that’s on the books,” Thomason said.

School officials have heard the physicals can cost $125 to $200 per student, for examinations that include vision, hearing, skin and temperature, he said. Petersburg typically has incoming classes of 20 to 40 students, he said.

He was not aware of any district that currently pays for school entrance physicals, including his own.

The physicals in question are separate from those required to play sports, and the law requiring entrance physicals is generally interpreted as exams due when a child enters school in Alaska for the first time, said Mary Bell, a school health nurse consultant within the state Division of Public Health.

No regulations were written to accompany the law and there is no statewide standard for what must be done during the exam, resulting in varying policies from district to district, she said by email.

She said some districts have the school nurse assess students in situations such as when there’s no exam on file from the children’s doctors but those assessments are meant more as a stopgap measure until the child can get a more thorough exam from a doctor.

In Alaska’s largest school district, in Anchorage, the board has interpreted the law as allowing for nurses to perform the screening without the need for a waiver, said the district’s director of nursing and health services, Nancy Edtl.

Board policy requires all new students to get a physical from a doctor, physician’s assistant or advanced nurse practitioner. If exams are not submitted by a certain point, the school nurse will do the screening. The policy calls for school nurses to do health screenings — including tests for vision, hearing and tuberculosis and a review of immunizations — for students who transfer in.

The Anchorage School District had 4,000 kindergarten students this year, district spokeswoman Heidi Embley said by email.

Edtl said most parents get the physicals done on their own, and that is preferred, because it is more in-depth than what a school nurse can provide. She said physicals comprise a small piece of the workload for school nurses in the district.

The Petersburg Pilot first reported on the new questions raised about the exams.

Rep. Beth Kerttula, D-Juneau, said she plans to dig into the legislative history and work toward a reasonable solutions for districts and students. Kerttula is one of the legislators to whom the Petersburg district reached out. She commended Thomason for being upfront about the issue and pursuing clear answers.

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