HEALTH AND SANITATION

RSA tit. XV, ch. 200

in effect

RSA 200:11 Investigation of Sanitary Conditions.

200:11. Investigation of Sanitary Conditions. The department of health and human services shall, upon complaint of any responsible person, investigate the sanitary conditions of any schoolhouse or building used for school purposes. Source. 1915, 35:1. 1921, 85, VIII:14. PL 123:11. RL 142:11. RSA 200:11. 1983, 291:1, I. 1995, 310:181, eff. Nov. 1, 1995.

RSA 200:11-a Investigation of Air Quality.

200:11-a. Investigation of Air Quality. I. The school principal, or designee shall annually investigate the air quality of any schoolhouse or building used for school purposes and report the findings by completing a survey provided by the department of education. The survey shall be established in rules adopted by the state board of education pursuant to RSA 541-A. The purpose of the investigation shall be to consider physical factors that can influence the air quality within the schoolhouse or building. The investigation shall require a physical assessment of the facilities, not a measurement of the air quality. The survey shall allow an evaluation of the following physical conditions that can impact air quality: general cleanliness, ventilation, moisture control, and chemical use and storage. The completed survey shall be filed after the annual inspection with the department of education, the local school board, and the local health officer. Survey responses shall remain on file for 5 years. Survey responses shall be reviewed during the 5 year school approval process and shall be a factor in the approval process for a public school. II. The department of education shall notify every public school in New Hampshire how to access the United States Environmental Protection Agency Tools for Schools program and shall encourage public schools to implement the program to help provide and maintain good indoor air quality in public school buildings. III. Any school principal or designee who has conducted a good faith report under RSA 200:11-a shall be immune from civil liability. Source. 2010, 319:1, eff. Jan. 1, 2011; 295:12, eff. Jan. 1, 2011 at 12:01 a.m. 2024, 226:7, eff. Sept. 17, 2024.

RSA 200:11-b Water Bottle Filling Stations in Schools.

200:11-b. Water Bottle Filling Stations in Schools. I. [Repealed.] II. All construction or renovation of public school buildings, including any approved project under RSA 198:15-c, shall be equipped with water bottle filling stations meeting the following requirements: (a) A water bottle filling station shall mean a water dispenser accessible to all people in compliance with the American with Disabilities Act (42 U.S.C. 12101 et seq.) that dispenses clean drinking water directly into a bottle or other drinking container. (b) Water bottle filling stations may be touchless for sanitary reasons. (c) Water bottle filling stations installed in public schools under this section shall: (1) Be regularly cleaned to maintain sanitary conditions; (2) Be maintained to ensure they function properly, including replacing filters as recommended by the manufacturers; and (3) Dispense clean, filtered, cooled drinking water. III. The local building inspection authority, pursuant to RSA 155-A, of school districts shall not approve the plans or specifications for a new public school building and for any addition or substantial renovation to an existing public school building unless the plans and specifications provide for: (a) A minimum of one water bottle filling station for every 200 people projected to occupy the building upon completion of the proposed construction. (b) A minimum of one water bottle filling station on each floor or wing of each building. (c) A minimum of one water bottle filling station located near cafeterias, gymnasiums, or outdoor recreation spaces and other high-traffic areas. (d) Water bottle filling stations may be integrated into drinking fountains, at a ratio of 1 combination unit for every 200 people. IV. Schools shall permit students to bring to school water bottles that: (a) Are made of a material that is not easily breakable; (b) Have lids to prevent spills; and (c) Are filled exclusively with water. V. The school board may enact a disciplinary policy regarding the misuse of water bottles by students or employees. Source. 2022, 149:1, eff. Sept. 5, 2022. 2023, 6:1, eff. June 25, 2023.

RSA 200:12 Requiring Changes; Condemnation.

200:12. Requiring Changes; Condemnation. If the department of health and human services shall find that such schoolhouse or building is in any respect a menace, or likely to become a menace, to the health or bodily welfare of the pupils or teachers, the department shall call the attention of the local board of health to the facts; and, if after a reasonable length of time the complaint has not been attended to in a satisfactory way, the department shall either order such changes as will in their judgment make the building safe and sanitary for school purposes or condemn the same and forbid its further use. Source. 1915, 35:2. 1921, 85, VIII:15. PL 123:12. RL 142:12. RSA 200:12. 1995, 310:175, 181, eff. Nov. 1, 1995.

RSA 200:13 Cost of Changes.

200:13. Cost of Changes. It shall be the duty of the school board of the district forthwith to make the changes ordered, and the cost of the same shall be a charge upon the district. Source. 1915, 35:3. 1921, 85, VIII:16. PL 123:13. RL 142:13.

RSA 200:14 Assessment of Cost.

200:14. Assessment of Cost. The selectmen shall assess the cost upon the ratable estate of the district in addition to money voted by the district or required by law for the support of schools. In anticipation of such assessment the school board may borrow money on the credit of the district to meet the charges incurred. Source. 1915, 35:3. 1921, 85, VIII:16. PL 123:14. RL 142:14.

RSA 200:26 Definition.

200:26. Definition. As used in this subdivision the word "child" shall mean any child who attends, or who should attend an elementary, junior high, or senior high school, and shall include any child who attends a public kindergarten or special class for disabled children which is an integral part of the local school district. Source. 1971, 499:1. 1990, 140:2, X, eff. June 18, 1990.

RSA 200:27 School Health Services.

200:27. School Health Services. The local board in each school district may provide school health services to include school nurse services and school physician services to every child of school age in the district as hereinafter provided. Source. 1971, 499:1, eff. Sept. 4, 1971.

RSA 200:27-a Consent of Parent or Legal Guardian Required.

200:27-a. Consent of Parent or Legal Guardian Required. A child's participation in any program that provides medical or dental treatment in any school setting shall require the explicit written consent of the child's parent or legal guardian. Source. 2022, 110:3, eff. July 26, 2022.

RSA 200:28 School Physician.

200:28. School Physician. Each school board may appoint one or more school physicians, legally qualified to practice medicine and currently licensed to practice in New Hampshire or immediately adjacent states, and may assign one to the schools in the district and may provide them with all proper facilities for the performance of their duties as relate to the school health program. Source. 1971, 499:1, eff. Sept. 4, 1971.

RSA 200:29 School Nurse; Certification.

200:29. School Nurse; Certification. I. A superintendent may nominate and school board appoint a school nurse to function in the school health program, and provide said nurse with proper facilities and equipment. A school nurse shall be a registered professional nurse currently licensed in New Hampshire and certified by the state board of education. II. (a) An individual shall have the following entry level requirements to be certified as a school nurse: (1) Have completed a board of nursing approved registered nursing program at the associate's degree level or higher under RSA 326-B; and (2) Have 3 years current experience in pediatric nursing or other related nursing areas. (b) An applicant for certification as a school nurse shall have the skills, competencies, and knowledge in the following areas: (1) In the area of delivery of the school nursing services, the skills and abilities to: (A) Assess student's health or situation through analysis of data collected and synthesize comprehensive data. (B) Identify outcomes and develop plans for individual students or situations including strategies and alternatives. (C) Implement interventions identified in the plan of care/action, coordinating care with school employees and evaluate outcome. (D) Consult with administration to provide health education and employ strategies to promote health, wellness, and a safe environment. (E) Systematically evaluate the progress for the quality of practice and effectiveness toward attainment of outcomes for promoting health and a safe environment. (2) In the area of school nursing, the applicant shall demonstrate the knowledge and ability to: (A) Provide quality nursing practice in a school setting. (B) Evaluate his or her nursing practices and continue professional development as required by a school district's professional development master plan. (C) Collaborate with students, families, school staff, and others in the conduct of school nursing practices. (D) Integrate ethical provisions and research findings into practice as a school nurse. (3) In the area of accountability, knowledge, skills, and application in: (A) Planning and delivering school nursing services factoring in safety, effectiveness, cost, and impact on nursing practice. (B) Providing leadership in the profession and professional nursing practice setting. (C) Managing school health services. (D) Complying with professional nursing practice standards, guidelines, relevant statutes, rules, and regulations. III. The state board of education shall adopt rules, pursuant to RSA 541-A, relative to: (a) The application process for certification under paragraph II. (b) Form and content of any forms required under paragraph II. (c) Application fees for certification under paragraph II. (d) Further rulemaking necessary for the proper administration of certification under paragraph II. IV. All school nurses hired after August 25, 2019 holding an associate's degree in nursing shall be enrolled in a registered nurse to bachelor of science in nursing program, and shall complete such program within 6 years of the date of hire. Source. 1971, 499:1, eff. Sept. 4, 1971. 2016, 285:2, eff. Aug. 20, 2016. 2019, 144:1, 2, eff. Aug. 25, 2019. 2023, 172:1, 2, eff. July 28, 2023.

RSA 200:30 School Dental Hygienist.

200:30. School Dental Hygienist. Any school board may employ for their district a dental hygienist who is a graduate of an accredited school of dental hygiene and is licensed by the state dental board. Said hygienist shall be under the supervision of a qualified dentist licensed to practice in New Hampshire. Source. 1971, 499:1, eff. Sept. 4, 1971.

RSA 200:31 School Health Personnel.

200:31. School Health Personnel. Any school board may employ or contract for its district a licensed practical nurse (LPN) or licensed nursing assistant (LNA) who shall hold an unencumbered current license in New Hampshire, to work under the supervision of the school registered nurse in accordance with rules adopted under RSA 541-A, by the board of nursing. Source. 1971, 499:1. 1997, 326:1. 2007, 41:1, eff. July 20, 2007.

RSA 200:32 Physical Examination of Pupils.

200:32. Physical Examination of Pupils. There shall be a complete physical examination by a licensed physician, physician associate, or advanced practice registered nurse of each child prior to or upon first entry into the public school system and thereafter as often as deemed necessary by the local school authority. The result of the child's physical examination shall be presented to the local school officials on a form provided by the local school authorities. No physical examination shall be required of a child whose parent or guardian objects thereto in writing on the grounds that such physical examination is contrary to the child's religious tenets and teachings. Source. 1971, 499:1. 1996, 277:1, eff. Aug. 9, 1996. 2009, 54:5, eff. July 21, 2009. 2025, 105:1, eff. June 17, 2025.

RSA 200:34 Special Examination.

200:34. Special Examination. Every child with a presenting problem and found to need further evaluation, after due consideration and evaluation by the appropriate school authority, shall be referred by the school physician or school administrator to the parents or guardian of said child for examination, and evaluation by an appropriate practitioner and if said parents fail or neglect to have said child so examined and fail to present the recommendations from said examiner within a reasonable period after the referral by the school to said parents, then said child may be examined by the school physician, or other qualified personnel. Source. 1971, 499:1, eff. Sept. 4, 1971.

RSA 200:35 Reporting of Defects or Disabilities.

200:35. Reporting of Defects or Disabilities. The parent or guardian of the child shall be informed or counseled concerning any defects or disabilities discovered and identified through observation, screening procedures or physical examinations. The school nurse may make home visits, arrange parent conferences at school or send written notices as determined pursuant to local school policy. Source. 1971, 499:1, eff. Sept. 4, 1971.

RSA 200:36 Medical Examination of School Personnel.

200:36. Medical Examination of School Personnel. All school personnel, to include but not limited to administrative, secretarial, maintenance, cafeteria and transportation personnel in each school district shall be required to have a pre-employment medical examination by a licensed physician qualified to practice medicine in at least one of the states of the United States of America. Any person who objects to all or part of any medical examination because of religious beliefs shall be exempt from said examination, except that no such exemption shall be granted if state or local authorities determine that such exemption would constitute a hazard to the health of persons exposed to the unexamined individual. The local school board shall further require additional medical examinations at specific intervals or upon the request of the local superintendent of schools during the period of employment. A written recommendation from the examining physician shall indicate that the employee is medically capable of performing his designated assignment. Source. 1971, 499:1, eff. Sept. 4, 1971.

RSA 200:37 Medical Examination of School Bus Operators.

200:37. Medical Examination of School Bus Operators. Notwithstanding the provisions of RSA 200:36, before employing any person as a school bus operator, the town or city governing body which pays for such transportation shall require that such person submit a certificate signed by a licensed physician setting forth the physician's findings as a result of the examination to determine the physical condition of drivers in accordance with the requirements of 49 CFR 391.41-391.49. Such certificate shall be submitted to the local governing body prior to the commencement of such employment, which shall retain a copy of such certification. Every 2 years thereafter, either prior to the commencement of the school year or prior to the reemployment of such person as a school bus operator, such governing body shall require submission of a like certificate, except that school bus operators attaining the age of 70 shall be required to undergo an annual examination and to submit a certificate annually. Source. 1971, 499:1. 1992, 69:1, eff. June 19, 1992.

RSA 200:38 Control and Prevention of Communicable Diseases; Duties of School Nurse.

200:38. Control and Prevention of Communicable Diseases; Duties of School Nurse. I. Each school nurse shall ensure that: (a) All children shall be immunized prior to school entrance in accordance with RSA 141-C:20-a. (b) [Repealed.] (c) All children shall have a complete physical examination prior to school entrance in accordance with RSA 200:32. II. If the provisions of paragraph I are not met, each school nurse shall be responsible for informing school administrators of the noncompliance and for assisting with meeting such requirements, unless the child is exempted under RSA 141-C:20-c. Source. 1971, 499:1. 1987, 193:8. 1996, 277:2. 2001, 83:2, II, eff. Aug. 18, 2001.

RSA 200:39 Exclusion From School.

200:39. Exclusion From School. Whenever any student exhibits symptoms of contagion or is a hazard to himself or others, he shall be excluded from the classroom and his parents or guardians shall be notified as soon as possible. Source. 1971, 499:1, eff. Sept. 4, 1971.

RSA 200:40 Emergency Care.

200:40. Emergency Care. Written policies shall be adopted by the local school board for the purpose of providing immediate and adequate emergency care for students and school personnel who sustain injury or illness during school hours, or during scheduled school activities. Source. 1971, 499:1, eff. Sept. 4, 1971.

RSA 200:40-a Administration of Oxygen by School Nurse.

200:40-a. Administration of Oxygen by School Nurse. A school nurse shall be permitted to administer oxygen to a pupil in a medical emergency without parental permission or a physician's order. Source. 2001, 83:1, eff. Aug. 18, 2001.

RSA 200:40-b Glucagon Administration.

200:40-b. Glucagon Administration. I. (a) The state board of education, after consultation with the department of health and human services, shall adopt rules pursuant to RSA 541-A for addressing incidents of hypoglycemia resulting in unconsciousness, seizure, and/or the inability to swallow in order to provide for the health and safety of children who have been medically identified as having diabetes. The rules shall provide that: (1) A parent or legal guardian of any child may authorize a school employee, or person employed on behalf of the school in cases where there is no school nurse immediately available, to administer glucagon to a child in case of an emergency, while at school or a school sponsored activity; (2) The glucagon shall be kept in a conspicuous place, readily available; and (3) Glucagon administration training may be provided by a licensed physician, physician associate, advanced practiced registered nurse, or registered nurse, however in no case shall school nurses be required to provide training; and the school administration shall allow school employees to voluntarily assist with the emergency administration of glucagon when authorized by a parent or legal guardian. (b) No school employee shall be subject to penalty or disciplinary action for refusing to be trained in glucagon administration. (c) A parent or legal guardian shall provide a diabetes management plan or physician's order, signed by the student's health care provider, that prescribes the care and assistance needed by the student including glucagon administration. II. The state board of education, in conjunction with the American Diabetes Association, and the New Hampshire chapter of American Academy of Pediatrics, shall develop standards and guidelines for the training and supervision of personnel, other than the school nurse, who provide emergency medical assistance to students under this section. Such personnel shall only be authorized to provide such assistance upon successful completion of glucagon administration training. III. No school teacher, school administrator, school health care personnel, person employed on behalf of the school, any other school personnel, nor any local educational authority shall be liable for civil damages which may result from acts or omissions in use of glucagon which may constitute ordinary negligence. This immunity shall not apply to acts or omissions constituting gross negligence or willful or wanton conduct. IV. Training on the administration of glucagon for school personnel, or those employed on behalf of the school, shall not be considered the delegation of nursing practice. V. The administration of glucagon by school personnel, or those employed on behalf of the school, shall not be considered the practice of nursing. Source. 2015, 20:1, eff. July 4, 2015. 2022, 215:1, eff. Aug. 16, 2022. 2025, 105:1, eff. June 17, 2025.

RSA 200:40-c Emergency Plans for Sports Related Injuries.

200:40-c. Emergency Plans for Sports Related Injuries. I. The local board of each school district or the governing body of each nonpublic school that includes any of the grades 4 through 12, shall establish an emergency action plan for responding to serious or potentially life-threatening sports related injuries. Each plan shall: (a) Document the proper procedures to be followed when a student sustains a serious injury or illness while participating in school sponsored sports or other athletic activity. (b) List the employees, team coaches, and licensed athletic trainers in each school who are trained in first aid or cardiopulmonary resuscitation that follow evidence-based guidelines set forth by the American Heart Association or other nationally recognized organization or association focused on emergency cardiovascular care. (c) Identify the employees, team coaches, or licensed athletic trainers responsible for carrying out the emergency action plan. (d) Identify the activity location, address, or venue for the purpose of directing emergency personnel. (e) Identify the equipment and supplies and location thereof needed to respond to the emergency. (f) Identify the location of any automated external defibrillators and personnel trained in cardiopulmonary resuscitation (CPR) and the use of the automated external defibrillator (AED). If the school has AEDs: (1) The school will regularly check and maintain the AED according to the manufacturer's instructions; and (2) At least one AED shall be readily accessible in a well-marked and safe place to each athletic event or venue where practices and competitions are held for use in responding to cardiac emergencies and shall not be locked in an office or be stored in a location that is not easily and quickly accessible. (3) AEDs shall be readily accessible, in accordance with guidelines set by the American Heart Association or other nationally recognized guidelines focused on emergency cardiovascular care, to each athletic venue where practices and competitions are held, in which pupils of the school are participating. (g) Document policies related to cooling for an exertional heat stroke victim consistent with guidelines established by the American College of Sports Medicine and the National Athletic Trainers' Association. (h) Require that for grades 6-12 an individual trained in cardiopulmonary resuscitation supervise organized school sponsored sports activities in which pupils of the school are participating. Source. 2021, 210:2, Pt. III, Sec. 1, eff. Sept. 1, 2022. 2024, 286:1, eff. Aug. 1, 2024 and Aug. 1, 2025. 2025, 209:1, eff. July 1, 2025.

RSA 200:40-d AED Fund.

200:40-d. AED Fund. There is hereby established in the state treasury the automated external defibrillator (AED) fund. The nonlapsing fund shall be kept separate and distinct from all other funds and shall be continually appropriated to the department of safety, division of fire and standards and training and emergency medical services for the purposes of this section. The fund shall be used to provide financial support for the procurement and distribution of AEDs to schools in accordance with emergency plans for sports related injuries under RSA 200:40-c. The division may accept gifts, grants, donations, and other moneys for this purpose. Source. 2025, 209:2, eff. July 1, 2025.

RSA 200:40-e Informational Materials Regarding Type 1 Diabetes.

200:40-e. Informational Materials Regarding Type 1 Diabetes. I. The department of education, in consultation with the department of health and human services, shall develop or identify existing informational materials on type 1 diabetes meeting the requirements of paragraph II. The informational materials shall be periodically updated as necessary, and made available to school districts by posting on the department of education's Internet website. Each school district shall make the informational materials from the department's website known or otherwise accessible to the parents or guardians of the students enrolled in the school district, in a manner determined by the school district, including, but not limited to, through the district's website or by other digital means. II. The informational materials may be in the form of links to existing related resources posted to the websites of any entities the department of education deems appropriate, but shall include, at minimum: (a) A description of type 1 diabetes; (b) A description of risk factors and warning signs associated with type 1 diabetes; (c) A recommendation that the parents or guardians of students displaying warning signs associated with type 1 diabetes should consult with the student's primary care provider to determine if screening for type 1 diabetes is appropriate; (d) A description of the screening process for type 1 diabetes and the implications of test results; and (e) A recommendation that, following a type 1 diagnosis, parents or guardians should consult with the student's primary care provider to develop an appropriate treatment plan. Source. 2025, 230:1, eff. July 15, 2025.

RSA 200:41 Appropriation.

200:41. Appropriation. A district may raise money to carry the provisions of this subdivision into effect. Source. 1971, 499:1, eff. Sept. 4, 1971.

RSA 200:42 Possession and Use of Epinephrine Permitted

200:42. Possession and Use of Epinephrine Permitted A pupil with severe, potentially life-threatening allergies may possess and self-administer epinephrine if the following conditions are satisfied: I. The pupil has the written approval of the pupil's health care provider and, if the pupil is a minor, the written approval of the parent or guardian. The school shall obtain the following information from the pupil's health care provider: (a) The pupil's name. (b) The name and signature of the licensed prescriber and business and emergency numbers. (c) The name, route, and dosage of medication. (d) The frequency and time of medication administration or assistance. (e) The date of the order. (f) A diagnosis and any other medical conditions requiring medications, if not a violation of confidentiality or if not contrary to the request of the parent or guardian to keep confidential. (g) Specific recommendations for administration. (h) Any special side effects, contraindications, and adverse reactions to be observed. (i) The name of each required medication. (j) Any severe adverse reactions that may occur to another pupil, for whom the epinephrine is not prescribed, should such a pupil receive a dose of the medication. II. The school principal or, if a school nurse is assigned to the pupil's school building, the school nurse shall receive copies of the written approvals required by paragraph I. III. The pupil's parent or guardian shall submit written verification from the health care provider confirming that the pupil has the knowledge and skills to safely possess and use epinephrine in a school setting. IV. If the conditions provided in this section are satisfied, the pupil may possess and use the epinephrine at school or at any school-sponsored activity, event, or program. V. In this section, "health care provider" includes any physician or health practitioner with the authority to write prescriptions. Source. 2003, 50:1, eff. Aug. 15, 2003. 2025, 204:2, eff. July 1, 2025.

RSA 200:43 Use of Epinephrine.

200:43. Use of Epinephrine. Immediately after using epinephrine during the school day, the pupil shall report to the nurse's office or principal's office to enable the nurse or another school employee to provide appropriate follow-up care. Source. 2003, 50:1, eff. Aug. 15, 2003. 2025, 204:2, eff. July 1, 2025.

RSA 200:44 Availability of Epinephrine.

200:44. Availability of Epinephrine. The school nurse or, if a school nurse is not assigned to the school building, the school principal shall maintain for a pupil's use at least one dose of epinephrine, provided by the pupil, in the nurse's office or in a similarly accessible location. Source. 2003, 50:1, eff. Aug. 15, 2003. 2025, 204:2, eff. July 1, 2025.

RSA 200:44-a Anaphylaxis Training Required.

200:44-a. Anaphylaxis Training Required. I. (a) Designated assistive personnel shall complete an anaphylaxis training program prior to providing or administering epinephrine at least every 2 years following completion of the initial anaphylaxis training program. Such training shall be conducted based on resources provided by the National Association of School Nurses, the Food and Allergy Anaphylaxis Network, or the New Hampshire School Nurses' Association. Training shall be conducted online or in person and, at a minimum, shall cover: (1) Techniques on how to recognize symptoms of severe allergic reactions, including anaphylaxis. (2) Standards and procedures for the storage and administration of epinephrine. (3) Emergency follow-up procedures. (b) The school nurse conducting the anaphylaxis training shall maintain a list of individuals who have successfully completed the anaphylaxis training program. (c) Designated assistive personnel shall be identified by the school nurse, in consultation with the principal, to ensure as many hours as possible of the school day are covered by at least one assistive person. II. Not later than January 1, 2017, the department of education, in consultation with the New Hampshire School Nurses' Association, shall develop and make available to all schools guidelines for the management of students with life-threatening allergies. The guidelines shall include, but not be limited to implementation of the following by a school nurse: education and training for designated unlicensed assistive personnel on the management of students with life-threatening allergies, including training related to the administration of epinephrine; procedures for responding to life-threatening allergic reactions; the development of individualized health care plans and allergy action plans for every student with a known life-threatening allergy; and protocols to prevent exposure to allergens. Not later than September 1, 2017, each school district, under the direction of a school nurse, shall implement a plan based on the guidelines developed pursuant to this section for the management of students with life-threatening allergies enrolled in the schools under its jurisdiction, and make such plan available to the public. Source. 2016, 39:2, eff. July 2, 2016. 2025, 204:2, eff. July 1, 2025.

RSA 200:44-b Supply of Epinephrine.

200:44-b. Supply of Epinephrine. I. A school district shall adopt a policy to and maintain a supply of epinephrine for use in an allergic emergency when a nurse is employed or contracted by the district. The nurse shall determine the quantity and type of medication the school should maintain. II. To obtain life-saving allergy medication for a school district, a health care practitioner may prescribe epinephrine in the name of a school district for use in life-saving allergy emergency situations. If epinephrine is used pursuant to this subdivision, the school nurse shall order a replacement within 5 business days. III. A pharmacist may dispense epinephrine pursuant to a prescription issued in the name of a school. A school, under the direction of the school nurse, shall maintain a supply of epinephrine for use in accordance with this subdivision. IV. A school may enter into an agreement with a manufacturer of epinephrine, third-party suppliers of epinephrine, or health care offices to obtain epinephrine at no charge or at fair-market prices or at reduced prices. A school district may accept gifts, grants or donations from foundations, organizations, or private parties to purchase epinephrine. V. Schools shall submit an annual report to the department of education summarizing the supply and use of epinephrine pursuant to this subdivision. Source. 2024, 12:1, eff. May 14, 2024. 2025, 204:2, eff. July 1, 2025.

RSA 200:44-c Epinephrine Fund.

200:44-c. Epinephrine Fund. There is hereby established in the state treasury the epinephrine fund. The nonlapsing fund shall be kept separate and distinct from all other funds and shall be continually appropriated to the department of education for the purposes of this section. The fund shall be used to provide financial support for the procurement and distribution of epinephrine to schools in accordance with RSA 200:44-b. The department may accept gifts, grants, donations, and other moneys for this purpose. Source. 2025, 204:2, eff. July 1, 2025.

RSA 200:45 Immunity.

200:45. Immunity. I. No school district, member of a school board, or school district employee shall be liable in a suit for damages as a result of any act or omission related to a pupil's use of epinephrine pursuant to RSA 200:43, if the provisions of RSA 200:42 have been met, unless the damages were caused by willful or wanton conduct or disregard of the criteria established in that section for the possession and self-administration of epinephrine by a pupil. II. No school that possesses and makes available epinephrine, member of its school board, school nurse, school district employee, agents or volunteers, no health care practitioner that prescribes epinephrine to a school, and no person that conducts the training described in RSA 200:44-a shall be liable for damages as a result of the administration or self-administration of epinephrine, the failure to administer epinephrine, or any other act or omission related to the possession or use of epinephrine, unless the damages were caused by willful or wanton misconduct. III. The administration of epinephrine by designated school personnel pursuant to the provisions of this subdivision shall not require licensure. IV. This section shall not be construed to eliminate, limit, or reduce any other immunity or defense that may be available under state law. Source. 2003, 50:1, eff. Aug. 15, 2003. 2016, 39:3, eff. July 2, 2016. 2025, 204:2, eff. July 1, 2025.

RSA 200:46 Possession and Self-Administration of Asthma Inhalers Permitted.

200:46. Possession and Self-Administration of Asthma Inhalers Permitted. A pupil may possess and use a metered dose inhaler or a dry powder inhaler to alleviate asthmatic symptoms, or before exercise to prevent the onset of asthmatic symptoms, if the following conditions are satisfied: I. The pupil has the written approval of the pupil's physician and, if the pupil is a minor, the written approval of the parent or guardian. The school shall obtain the following information from the pupil's physician: (a) The pupil's name. (b) The name and signature of the licensed prescriber and business and emergency numbers. (c) The name, route, and dosage of medication. (d) The frequency and time of medication administration or assistance. (e) The date of the order. (f) A diagnosis and any other medical conditions requiring medications, if not a violation of confidentiality or if not contrary to the request of the parent or guardian to keep confidential. (g) Specific recommendations for administration. (h) Any special side effects, contraindications, and adverse reactions to be observed. (i) At least one emergency telephone number for contacting the parent or guardian. (j) The name of each required medication. II. The school principal or, if a school nurse is assigned to the pupil's school building, the school nurse shall receive copies of the written approvals required by paragraph I. III. The pupil's parent or guardian shall submit written verification from the physician confirming that the pupil has the knowledge and skills to safely possess and use an asthma inhaler in a school setting. IV. If the conditions provided in this section are satisfied, the pupil may possess and use the inhaler at school or at any school sponsored activity, event, or program. V. In this section, "physician" includes any physician or health practitioner with the authority to write prescriptions. Source. 2003, 51:3, eff. Aug. 15, 2003.

RSA 200:47 Immunity.

200:47. Immunity. No school district, member of a school board, or school district employee shall be liable in a suit for damages as a result of any act or omission related to a pupil's use of an inhaler if the provisions of RSA 200:46 have been met, unless the damages were caused by willful or wanton conduct or disregard of the criteria established in that section for the possession and self-administration of an asthma inhaler by a pupil. Source. 2003, 51:3, eff. Aug. 15, 2003.

RSA 200:48 Air Quality in Schools.

200:48. Air Quality in Schools. The school board of each school district shall develop and implement a policy governing air quality issues in schools. The policy shall address methods of minimizing or eliminating emissions from buses, cars, delivery vehicles, maintenance vehicles, and other motorized vehicles used for transportation on school property taking into account the state anti-idling and clean air zone policies established by the department of environmental services. Source. 2010, 100:1, eff. Jan. 1, 2011.

RSA 200:49 Head Injury Policies for Student Sports.

200:49. Head Injury Policies for Student Sports. Education is the key to identification and appropriate management of all concussions. The school board of each school district shall develop guidelines and other pertinent information and forms for student sports to inform and educate coaches, student-athletes, and student-athletes' parents or guardians of the nature and risk of concussion and head injury including continuing to play after concussion or head injury. On an annual basis, a school district or school shall distribute a concussion and head injury information sheet to all student-athletes. The Brain Injury Association of New Hampshire is available to educate and assist the public with implementing and/or updating concussion management protocols. Source. 2012, 234:2, eff. Aug. 17, 2012. 2014, 42:1, eff. July 26, 2014.

RSA 200:50 Removal of Student-Athlete.

200:50. Removal of Student-Athlete. I. A school employee coach, official, licensed athletic trainer, or health care provider who suspects that a student-athlete has sustained a concussion or head injury in a practice or game shall remove the student-athlete from play immediately. II. A student-athlete who has been removed from play shall not return to play on the same day or until he or she is evaluated by a health care provider and receives medical clearance and written authorization from that health care provider to return to play. The student-athlete shall also present written permission from a parent or guardian to return to play. III. No person who authorizes a student-athlete to return to play shall be liable for civil damages resulting from any act or omission in the rendering of such care, other than acts or omissions constituting gross negligence or willful or wanton misconduct. Source. 2012, 234:2, eff. Aug. 17, 2012.

RSA 200:51 School Districts; Limitation of Liability.

200:51. School Districts; Limitation of Liability. An employee of a school administrative unit, school, or chartered public school, or a school volunteer, pupil, parent, legal guardian, or employee of a company under contract to a school, school district, school administrative unit, or chartered public school, shall be immune from civil liability for good faith conduct arising from or pertaining to the injury or death of a student-athlete provided the action or inaction was in compliance with this subdivision and local school board policies relative to the management of concussions and head injuries. This limitation of liability shall extend to school-sponsored athletic activities. A school district or school may provide concussion guidelines to other organizations sponsoring athletic activities on school property, however the school district or school shall not be required to enforce compliance with such guidelines. Source. 2012, 234:2, eff. Aug. 17, 2012.

RSA 200:52 Definitions.

200:52. Definitions. As used in this subdivision: I. "Health care provider" means a person who is licensed, certified, or otherwise statutorily authorized by the state to provide medical treatment and is trained in the evaluation and management of concussions. II. "School property" means school property as defined in RSA 193-D:1, V. III. "Student-athlete" means a student involved in any intramural sports program conducted outside the regular teaching day or competitive student sports program between schools in grades 4-12. IV. "Student sports" means intramural sports programs conducted outside the regular teaching day for students in grades 4-12 or competitive athletic programs between schools for students in grades 4-12. V. "Head injury" means injuries to the scalp, skull, or brain caused by trauma, and shall include a concussion which is the most common type of sports-related brain injury. Source. 2012, 234:2, eff. Aug. 17, 2012. 2013, 19:1, eff. July 15, 2013. 2014, 42:2, eff. July 26, 2014.

RSA 200:53 Definitions.

200:53. Definitions. In this subdivision: I. "Administer" means the direct provision of a bronchodilator, spacer, or nebulizer to an individual. II. "Asthma" means a chronic lung disease that inflames and narrows the airways. It causes recurring periods of wheezing, chest tightness, shortness of breath, and coughing. For the purpose of this subdivision, "asthma" also includes "reactive airway disease," commonly referred to as RAD. III. "Bronchodilator" means any medication used for the quick relief of asthma symptoms that dilates the airways and is recommended by the National Heart, Lung, and Blood Institute's national asthma education and prevention program guidelines for the treatment of asthma, such bronchodilators may include an orally inhaled medication that contains a premeasured single dose of albuterol or albuterol sulfate delivered by a nebulizer (compressor device), or by a pressured metered dose inhaler used to treat respiratory distress, including, but not limited to, wheezing, shortness of breath, and difficulty breathing, or another dosage of a bronchodilator recommended in the guidelines for the treatment of asthma. IV. "Designated unlicensed assistive personnel" means a school employee or agent of a school designated by the school nurse, who has completed the New Hampshire School Nurses' Association approved training required to provide or administer bronchodilators, spacers, or nebulizers. Designated unlicensed assistive personnel shall complete an asthma training program prior to providing or administering a bronchodilator, spacer, or nebulizer made available by the school nurse and at least annually following completion of the initial asthma training program. Such training shall be conducted by the school nurse based on resources provided by the New Hampshire School Nurses' Association, the National Association of School Nurses, and the American Lung Association. Training shall be conducted in person and at a minimum shall address techniques on how to recognize symptoms of severe respiratory distress or asthma, and standards and procedures for the storage and administration of a bronchodilator with a spacer or nebulizer. The school nurse shall maintain a current list of those individuals who have successfully completed the asthma training program. V. "Health care practitioner" means a person who is licensed to prescribe, administer, or distribute controlled drugs. VI. "Provide" means to supply a bronchodilator to an individual. VII. "School" means any public or private elementary, middle, junior high, or senior high school. VIII. "School nurse" means a registered nurse (RN) licensed by the New Hampshire board of nursing employed by a school district or a school. IX. "Self-administration" means a student or other person's discretionary use of a bronchodilator, spacer, or nebulizer, whether provided by the student or by a school nurse or designated school personnel pursuant to this subdivision. Source. 2016, 45:1, eff. July 2, 2016.

RSA 200:54 Supply of Bronchodilators, Spacers, or Nebulizers.

200:54. Supply of Bronchodilators, Spacers, or Nebulizers. I. A school board may authorize a school nurse who is employed by the school district and for whom the board is responsible to maintain a supply of asthma-related rescue medications at the school. The nurse shall determine the quantity of medication the school should maintain. II. To obtain asthma rescue medications for a school district, a health care practitioner may prescribe bronchodilators, spacers, or nebulizers in the name of a school district for use in asthma emergency situations. III. A pharmacist may dispense bronchodilators, spacers, or nebulizers pursuant to a prescription issued in the name of a school. A school, under the direction of the school nurse, may maintain a supply of bronchodilators, spacers, or nebulizers for use in accordance with this subdivision. IV. A school may enter into an agreement with a manufacturer of bronchodilators, spacers, or nebulizers, third-party suppliers of bronchodilators, spacers, or nebulizers, or health care offices to obtain bronchodilators, spacers, or nebulizers at no charge or at fair-market prices or at reduced prices. A school district may accept gifts, grants or donations from foundations, organizations, or private parties to purchase bronchodilators, spacers, or nebulizers. V. A school that possesses and makes available a supply of bronchodilators, spacers, or nebulizers pursuant to this subdivision shall maintain an annual report summarizing the use of the bronchodilators, spacers, or nebulizers. Source. 2016, 45:1, eff. July 2, 2016.

RSA 200:55 Administration of Bronchodilator, Spacer, or Nebulizer.

200:55. Administration of Bronchodilator, Spacer, or Nebulizer. I. A school nurse and designated unlicensed assistive personnel may administer or make available to self-administer a bronchodilator, spacer, or nebulizer to a student who has been diagnosed with asthma for use in emergency or other situations as determined by the school nurse provided that: (a) The school has on file an asthma action plan for the student which shall be filed annually and updated as necessary with the school and includes an order from the student's health care provider to provide the student with an asthma rescue inhaler, including dosage information and permission for the student to use the school's stock in the event of an emergency; and (b) The student's parent/guardian has provided written permission to the school nurse to administer a bronchodilator, spacer, or nebulizer from the school's supply. II. The school nurse shall notify the student's parent or legal guardian whenever a bronchodilator, spacer, or nebulizer from the emergency stockpile is administered to a student. The school nurse shall make the notification as soon as practicable in accordance with the contact information on file at the school. Source. 2016, 45:1, eff. July 2, 2016.

RSA 200:56 Department of Education Guidance Provided to Schools.

200:56. Department of Education Guidance Provided to Schools. No later than 90 days following July 2, 2016, the department of education, in consultation with the New Hampshire School Nurses' Association and the American Lung Association, shall provide guidelines to all schools for the management of students with asthma. The guidelines shall include, but not be limited to, implementation of education and training for designated unlicensed assistive personnel on the management of students with asthma, including training related to the administration of a bronchodilator with a spacer or nebulizer, and procedures for responding to life-threatening respiratory distress. Source. 2016, 45:1, eff. July 2, 2016.

RSA 200:57 Immunity.

200:57. Immunity. I. No school district, school district employee, member of a school board, school nurse, designated unlicensed assistive personnel, or agent or volunteer of a school district shall be liable in a suit for damages as a result of any act or omission related to a student's use of a bronchodilator, spacer, or nebulizer pursuant to this subdivision, except for damages caused by willful or wanton conduct or disregard of the requirements established in this subdivision. II. The administration of a bronchodilator, spacer, or nebulizer in accordance with this subdivision shall be considered to be the administration of emergency medication in school. If delegated the task of administering a bronchodilator, spacer, or nebulizer by a school nurse, the designated unlicensed assistive personnel shall not require licensure as a health care provider. III. This section shall not be construed to eliminate, limit, or reduce any other immunity or defense that may be available under state law. Source. 2016, 45:1, eff. July 2, 2016.

RSA 200:58 Definitions.

200:58. Definitions. In this subdivision: I. "Dyslexia" means a specific learning disability that is: (a) Neurobiological in origin; (b) Characterized by difficulties with accurate or fluent word recognition and by poor spelling and decoding abilities that typically result from a deficit in the phonological component of language; and (c) Often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction, and may include secondary consequences such as reading comprehension problems and reduced reading experience that can impede growth of vocabulary and background knowledge. II. "Potential indicators or risk factors of dyslexia and related disorders" means indicators that include, but shall not be limited to, difficulty in acquiring language skills, inability to comprehend oral or written language, difficulty in rhyming words, difficulty in naming letters, recognizing letters, matching letters to sounds, and blending sounds when speaking and reading words, difficulty recognizing and remembering sight words, consistent transposition of number sequences, letter reversals, inversions, and substitutions, and trouble in replication of content. III. "Related disorders" include disorders similar to or related to dyslexia, such as a phonological processing disorder, reading fluency disorder, and dysphasia. Source. 2016, 262:1, eff. Aug. 14, 2016.

RSA 200:59 Screening and Intervention for Dyslexia and Related Disorders.

200:59. Screening and Intervention for Dyslexia and Related Disorders. I. School districts shall screen all public school and chartered public school students, including English learners, using an evidence-based screener for the identification of potential indicators or risk factors of dyslexia and related disorders upon entry to public school. The initial screening shall be completed no later than 60 school days of a student entering public school in kindergarten through third grade. The screening shall be repeated one additional time during the current school year, and repeated at a minimum of twice yearly through third grade to monitor progress. I-a. If any such screening determines that a student fails to meet relevant benchmarks for grade-typical development in specific foundational skills, then the school must complete a secondary assessment within 30 days to determine whether the school shall provide such student with modified, differentiated, or supplementary evidence-based reading instruction intervention or refer the student to special education for further evaluation. The school shall inform the student's parent or legal guardian of the screening results. If a special education referral is made for further evaluation, the state's required timeline shall be followed. During this time general education accommodations shall be initiated within 21 days of the initial screening, and continue until a special education determination is made. II. The student's school district or chartered public school shall provide age-appropriate, evidence-based, intervention strategies to begin by the January 1 of the school year for any student who is identified as having characteristics that are associated with potential indicators or risk factors of dyslexia and related disorders. III. The parent or legal guardian of any student who is identified by the public school as having characteristics that are associated with potential indicators or risk factors of dyslexia and related disorders shall be notified and provided with all screening information and findings, in addition to periodic formal screening results based on individual written intervention and support plans developed with the student's parents or legal guardian. IV. A parent or legal guardian of any student who is identified as having characteristics that are associated with potential indicators or risk factors of dyslexia and related disorders has the right to submit the results of an independent evaluation from a licensed reading or intervention specialist trained in dyslexia and related disorders for consideration by the student's school district. A parent or legal guardian who submits an independent evaluation shall assume all fiscal responsibility for that independent evaluation. Source. 2016, 262:1, eff. Aug. 14, 2016. 2023, 151:1, eff. Sept. 26, 2023.

RSA 200:60 Reading Specialist.

200:60. Reading Specialist. I. The commissioner of the department of education shall issue a request for proposals pursuant to RSA 21-G to secure the contract services of a reading specialist, or employ a staff member who is a reading specialist, to enable the department to provide school districts with the support and resources necessary to assist students with dyslexia and related disorders and their families. The reading specialist shall be qualified by education and experience in accordance with paragraph II and shall provide technical assistance for dyslexia and related disorders to school districts. II. The reading specialist shall: (a) Be trained and certified in best practice interventions and treatment models for dyslexia, with expertise in related disorders, and dysgraphia. (b) Have a minimum of 3 years of field experience in screening, identifying, and treating dyslexia and related disorders. (c) Be responsible for the implementation of professional awareness. (d) Serve as the primary source of information and support for school districts to address the needs of students with dyslexia and related disorders, and dysgraphia. III. The commissioner shall submit a report assessing the effectiveness of the reading specialist in complying with the requirements of this section, to the speaker of the house of representatives, the senate president, the chairpersons of the house and senate education committees, and the governor no later than November 1, 2018, and annually thereafter. Source. 2016, 262:1, eff. Aug. 14, 2016. 2017, 156:152, eff. July 1, 2017. 2023, 47:1, eff. May 19, 2023.

RSA 200:61 Teacher Professional Development and Training.

200:61. Teacher Professional Development and Training. I. No later than June 30, 2017, the reading specialist shall develop and make available a program to ensure all New Hampshire teachers and school administrators have access to materials to support professional awareness of best practices on: (a) Recognition of the characteristics of dyslexia and related disorders, and dysgraphia. (b) Evidence-based interventions and accommodations for dyslexia and related disorders, and dysgraphia. II. The reading specialist and the council for teacher education established in RSA 190 shall collaborate to ensure that all teacher education programs offered at New Hampshire's public institutions of higher education provide explicit professional awareness of best practices on: (a) Recognition of characteristics of dyslexia and related disorders, and dysgraphia. (b) Evidence-based interventions and accommodations for dyslexia and related disorders, and dysgraphia. Source. 2016, 262:1, eff. Aug. 14, 2016.

RSA 200:62 Dyslexia Resource Guide.

200:62. Dyslexia Resource Guide. No later than June 30, 2017, the reading specialist shall develop and publish on the department of education's Internet website, a reading support resource guide to be used by school districts as a resource. The reading specialist shall solicit the advice of experts in the fields of dyslexia and related disorders, and dysgraphia in the development of the guide. The reading specialist shall update the guide as necessary. Source. 2016, 262:1, eff. Aug. 14, 2016.

RSA 200:63 Head Injuries; Return to Learning Policy and Plan.

200:63. Head Injuries; Return to Learning Policy and Plan. I. The department of education shall collaborate with the Brain Injury Association of New Hampshire to develop a concussion and traumatic brain injury return to learning policy and plan for school districts. The plan shall include a recommendation on school-based concussion and brain injury in-service training. II. The school board of each school district shall adopt a concussion and traumatic brain injury return to learning policy school education program. Source. 2020, 38:16, eff. Sept. 27, 2020.

RSA 200:64 Commission Established.

200:64. Commission Established. There is a commission established to study the health and well-being of children in the state and to identify the gaps in mental and physical health services provided to children. The commission shall be administratively attached to the department of education. I. Notwithstanding RSA 14:49, the members of the commission shall be as follows: (a) Two members of the house of representatives, appointed by the speaker of the house of representatives; (b) One member of the senate from the democratic party and one member of the senate from the republican party, appointed by the president of the senate; (c) Two health care professionals licensed in the state, appointed by the governor; (d) One medical practitioner licensed in the state specializing in either traditional or holistic medicine, appointed by the speaker of the house; (e) One child psychologist licensed in the state, appointed by the senate president; (f) One mental health care provider, appointed by the speaker of the house; (g) Two teachers certified by the department of education, one of whom is certified in special education, appointed by the governor; (h) One dietitian, as defined in RSA 326-H:3, appointed by the senate president; (i) One member of state or local law enforcement, appointed by the speaker of the house; and (j) Three parents of children residing in the state, one of whom is appointed by the governor, one of whom is appointed by the speaker of the house, and one of whom is appointed by the senate president. II. Legislative members of the commission shall receive mileage at the legislative rate when attending to the duties of the commission. III. The commission shall study: (a) The usage of individualized education programs (IEPs) in schools and trends within IEPs over time; (b) The child usage rate of pharmaceuticals with psychoactive effects; (c) Reports of diagnosed mental health issues in youth; (d) The proportion of students that know of someone who has experienced a mental health crisis; (e) Changes in the prevalence of childhood cancer and long-term diseases; (f) Changes in autism spectrum disorder and attention deficit disorder diagnoses; (g) The amount of mental health services provided to minors and associated trends with such services; (h) The prevalence of criminal street gangs, as defined in RSA 651:6, I-a(c) in New Hampshire; (i) The number of incidents of violence in public schools and the impact such incidents have on students; (j) Truancy and attendance rates in public schools; (k) The prevalence of adverse childhood experiences and the effect such experiences have on children; (l) Childhood exposure to pornographic content; and (m) Youth homelessness rates. IV. The members of the study commission shall elect a chairperson from among the members. The first meeting of the commission shall be called by the first-named house member. The first meeting of the commission shall be held within 45 days of the effective date of this section. Eight members of the commission shall constitute a quorum. V. The commission shall report its findings and any recommendations for proposed legislation to the speaker of the house of representatives, the president of the senate, the house clerk, the senate clerk, the governor, and the state library annually on November 1 of each year. Source. 2026, 101:1, eff. May 28, 2026.

Source: New Hampshire General Court (gc.nh.gov)URL: https://gc.nh.gov/rsa/html/NHTOC/NHTOC-XV-200.htmFetched: 10/20/2026