(2) The school health services program shall include but not be limited to the following:

• (a) Each local school system shall have a written policy providing for a physical examination of every child entering school for the first time. A doctor of medicine, osteopathic physician, physician assistant, certified nurse practitioner, or a properly trained public health nurse shall perform this examination. No child shall be admitted to school without proof of immunization except those who are exempt by Statuteas provided in T.C.A. § 49-6-5001.

• (b) Each local school system shall have a written policy providing for a physical examination of every student participating in interscholastic athletics. A doctor of medicine, osteopathic physician, physician assistant, or certified nurse practitioner shall perform this examination.

• (c) Each local school system shall have a written policy for excluding pupils with communicable diseases and for readmitting them following recovery. In the case of diseases (listed in Regulations Governing Communicable Diseases in Tennessee: Tennessee Department of Health) the policy shall be in accordance with the recommendations of the State Department of Health as approved by the State Commissioner of Education.

• (d) Each local school system shall have a written policy for handling drug/alcohol problems that may arise in the schools.

• (e) Each local school system shall develop procedures for reporting suspected cases of child abuse and neglect as provided in T.C.A. § 37-1-403.

• (f) After an offer of employment has been made to an applicant and prior to the commencement of the employment duties, each employee shall present a physician's certificate showing a satisfactory health record. Employees shall present a certificate thereafter at intervals determined by the State Department of Health and approved by the State Commissioner of Education. The provisions of this subsection shall be administered in a manner consistent with the Americans with Disabilities Act (42 U.S.C.A. §§ 12101 et seq.) and the associated regulations (29 C.F.R. Part 1630 et. seq).

(g) HIV, HIV-Related Illness and AIDS.

(a) LEAs are authorized to implement a program that identifies public school children who are at risk for obesity. Those schools systems that choose to carry out such a program shall:

• (1) Have sufficient number of current school staff or school volunteers trained in taking a body mass index (BMI) to meet the requirements of this part. The department of health shall develop and provide training materials to the LEAs;

• (2) Complete a body mass index for age (BMI-for-age), as defined by the centers for disease control and prevention, on every child enrolled for classes in the school system whose parents or guardians have not requested exclusion from the testing; and

• (3) 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.

(b) School systems that carry out the program shall transmit the results of the testing for each student to the department of health.

(a) The department of health, with the assistance of the department of education, shall provide a framework for LEAs to use in developing a program that shall include, but not be limited to:

• (1) Providing standard practices for maintaining confidentiality;

• (2) Providing necessary information to LEAs annually, explaining the method for determining a BMI-for-age and the tables that should be used to determine if a child may be at risk of being overweight, or if the child is overweight or underweight based upon the BMI-for-age.

• (3) Developing and disseminating to LEAs annually a form that should be used to report the student results from individual schools and from the LEA to the department of health;

• (4) Developing and disseminating a sample notification to all LEAs that can be used as the model for the health report card to notify parents or guardians of the child's BMI results, along with basic educational information on what the results mean, the applicable health risks for a child who is overweight and what the parents or guardians should do with the information; and

• (5) Working with representatives from the department of education, state health professional associations and national health related organizations in the design of the form and sample notification.

(3) Assist LEAs in the provision of student health services, including, but not necessarily limited to:

• (A) Medical screenings;

• (B) Acute care;

• (C) Health opinions for teacher referrals;

• (D) Child abuse assessments;

• (E) Counseling for students with chronic diseases; and

• (F) Counseling for students who are engaging in, or who may be at risk of engaging in, behavioral patterns that jeopardize physical or mental health and well-being;

These guidelines describe requirements for LEAs to condcut health screenings for students.