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Medical inspection legislation online

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Contents

PAGE

Map 2

Medical Inspection Legislation in America 5

Principal Features of Laws 6

Abstract of Laws and Regulations 7

Provisions New Laws Should Include 11

California 12

Colorado 14

Connecticut ,....15

— District of Columbia 17

Indiana 28

Louisiana 30

Maine 33

Massachusetts 35

' Minnesota 40

~ New Jersey 42

New York 43

North Dakota 44

Ohio 44

■ Pennsylvania 45

-^ Utah 48

Vermont 49

Virginia 49

Washington 50

- - West Virginia 50



3



Medical Inspection Legislation in
America

The first state law providing for the medical inspection of school
children appears to have been passed by Connecticut in 1899.
It did not provide for the complete sort of inspection now carried
on in many cities and states, but only for the testing of eyesight
by teachers ev^ery three years. Complete medical inspection
with examinations for the detection of physical defects was first
provided for by state enactment in the permissive law of New
Jersey passed in 1903. This was followed by the mandatory
law of Massachusetts in 1906, which has been several times
amended, and which has served as the basis for a majority of the
bills which have since been presented in other state legislatures.

At the present time (May, 191 1), six states have mandatory
laws, ten have permissive ones, and in two states and the District
of Columbia medical inspection is carried on under regulations
promulgated by the boards of health and having the force of
law. The fact that the Massachusetts statute is the oldest of
the laws now in force shows that the whole body of legislative
enactments which crystallize the views, beliefs and results of
experience of educators and physicians, is of distinctly recent
origin.

Nevertlieless, the past five years have furnished a large body
of experience under varying conditions and in widely separated
localities, and the lessons of this experience can be read in the
substantial agreement of a majority of the laws in several salient
features. This is graphically shown by the tabular presentation
of the principal features of the different laws and regulations
printed on page 6.

On four points there is substantial agreement. The first is
that the administration of the provisions of the laws is placed in
the hands of the school authorities. The second, third and
fourth are respectively placing in the hands of school physicians
the inspection for contagious diseases, the physical examin-
ations, and the inspection of teachers, janitors and buildings.
In six cases provision is made for testing of vision and hearing
by the teachers.

A clear idea of the {principal provisions of the different laws
may be gained by reading the abstract beginning on page 7.

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Abstract of Laws and Regulations

1. California

Adopted 1909 — Permissive — Applies where adopted

Administered by school authorities

Provides for health and development supervision of teachers

and pupils
Inspectors may be either physicians or educators

2. Colorado

Adopted 1909 — Mandatory — Applies to all public schools

Administered by school authorities

Teachers or principals test sight, hearing and breathing
of all pupils annually

School authorities report to parents mental, moral or physical
defectiveness discovered

Enforcement by State Bureau of Child and Animal Protec-
tion

3. Connecticut

Adopted 1907 — Permissive — Applies where adopted
Administered by school authorities
Physicians inspect children for contagious diseases
Physicians may examine teachers, janitors and school

premises
Physicians conduct sight, hearing and physical examinations

annually
Defects reported to parents
School authorities may appoint school nurses

4. District of Columbia

Regulations of Health Officer and Board of Education
Adopted in present form in 1907 — Mandatory — Applies to

all public schools
Administered by health authorities
Physicians examine for contagious diseases
Physicians examine sanitary conditions of buildings
Physicians may examine teachers and janitors

5. Indiana

Adopted 191 1 — Permissive — Applies where adopted
Administered by school authorities

7



8

Physicians inspect chikiron f(ir contagious diseases

Teachers may test si.nht aiul Iicaring annually

Physicians conduct physical examinations

Defects re}X)rted to parents

Not more than 2000 children for one physician

Compensation of physician not less than $5 for each school

month
Physicians may examine teachers, janitors and buildings
If parents are too poor to provide necessary medical treat-
ment it shall be paid for from public funds
rinalt\- of $5 to ;?50 for violation of provisions of act

6. Louisiana

Adopted 191 1 — Regulations of Sanitary Code of State
Board of Health having force of law — Mandatory —
Applies to all public schools

Administered by school authorities

Principal of each school makes monthly report on physical
condition of children and sanitary condition of build-
ings on blanks furnished by State Board of Health

Principals and teachers exclude children suffering from
contagious disease

7. Maine

Adopted 1909 — Permissive — Applies to cities and towns of

less than 40,000
Administered by school authorities
No more than 1000 pupils to a physician
Physicians inspect children for contagious diseases
Physicians may examine teachers, janitors and buildings
Tests of sight and hearing annually by teachers or physicians
Physical examinations annually by physicians
Defects reported to parents

8. Massachusetts

Adopted 1906 — amended 1910 — Mandatory — Applies to all

public schools
Administered by school or health authorities
Physicians inspect children for contagious diseases
Physicians may examine teachers, janitors and buildings
Tests of sight and hearing made by teachers annually
Physicians make physical examinations of children annually
Defects reported to parents
Normal schools train students in testing sight and hearing



Physicians conduct examinations of minors applying for age
and schooling certificates
9. Minnesota

Regulations of Board of Health having force of law

Adopted 1910 — Mandatory — Applies to all public schools

Administered by health authorities

Physicians examine for contagious diseases

Physicians may inspect teachers, janitors and buildings

Physicians conduct physical examinations annually

Defects reported to parents

Teachers test sight and hearing annually

Normal schools train pupils in testing sight and hearing
ID. New Jersey

Adopted 1909 — Mandatory — Applies to all public schools

Administered by school authorities

Physicians examine for contagious diseases

Physicians conduct physical examinations, including sight
and hearing tests

Defects reported to parents

Physicians deliver hygiene lectures to teachers

Parents and guardians may be proceeded against as dis-
orderly persons for failure to remove any pathological
condition which may cause a child's exclusion from
school

11. New York

Adopted 1 9 10 — Permissive

Authorizes school authorities to expend school funds for the
support of medical inspection

12. North Dakota

Adopted 191 1 — Permissive — Applies where adopted
Administered by school authorities
Physicians conduct physical examinations annually
Defects reported to parents

Co-operates with Board of Health to curb contagious
disease and to secure treatment for indigent children

13. Ohio

Adopted 1910 — Permissive — Applies to cities
Administered by school authorities, but powers may be

delegated to health authorities
Physicians inspect children and vschools
School nurses may be employed



10

14. Pennsylvania

Adopti'd 11)1 1 — Mandatory in districts of first and second
class — IVrniissivc in districts of third and fourth class.
Districts of first class arc those of more than 500,000
iwpulation, second class from 30,000 to 500,000, third
class 5,000 to 30,000, and fourth class less than 5,000

Administered by school authorities

Physicians conduct complete physical examinations of
children annually

Plusicians make sanitary inspection of school premises
annually

In districts of fourth class medical inspectors are appointed
by State Commissioner of Health

Provision for employment of graduate nurses

15. Utah

Adopted 191 1 — Mandatory — Applies to all public schools

Administered by school authorities

Teachers or physicians examine all children annually for

defect of sight or hearing, defective teeth or mouth

breathing
Defects reported to parents

16. Vermont

Adopted 1 910 — Permissive — Applies where adopted

Administered by school authorities

Physicians inspect pupils as provided by rules of State

Board of Health
On request, physicians examine pupils of private schools

17. Virginia

Adopted 1910 — Permissive — Applies where adopted
Administered by school authorities

Authorizes school boards to support systems of medical
inspection

18. Washington

Adopted 1909 — Permissive — Applies to cities of first class
Administered by school authorities

Authorizes school boards to appoint medical inspectors who
shall report monthly on health conditions in each school

19. West Virginia

Adopted 191 1 — Mandatory in cities, permissive in country

districts
Administered by school authorities



II

Physicians inspect children for contagious diseases
Physicians conduct physical examinations annually
Physicians, on request of board, report on lighting, ventila-
tion, etc.
School nurses may be employed



Provisions New Laws Should Include

A comparative study of the provisions of the different laws
shows that with the added experience gained through knowledge
of how the older measures have met the test of time, school
physicians and educators have incorporated in some of the more
recent measures features which are genuine improvements, and
which should be provided for in bills for new medical inspection
acts and amendments of the old ones. The following are the
features which it would seem ought to be included in bills for
new medical inspection laws:

1. A provision that the administration of the system of medical
inspection shall be in the hands of the school authorities, but
that they shall have the power to delegate their authority to the
local health officials, and that in the treatment of cases of con-
tagious diseases the school and health authorities shall co-operate.
The principle here involved is that routine medical inspection
and physical examinations arc primarily for insuring the health
and vitality of the individual child and are preferably handled
by the school authorities who are charged with his daily care.
The curbing of epidemics of contagious disease is primarily for
the protection of the community, and in this the health authorities
have the right as well as the duty to intervene. Examples of
such provisions as those suggested are to be found in the laws
of North Dakota and Ohio.

2. Provision for inspection by school physicians to detect and
exclude cases of contagious disease.

3. Provision for annual examinations of all children by school
physicians to detect any physical defects which may prevent the
children from receiving the full benefit of their school work or
which may require that the work be modified to avoid injury to



12

them. This pnn ision sluuild iiuliulo the requirement that
parents Ik* notilietl of any defects discovered.

4. Provision that annual tests of vision and hearing shall be
conducted by the teachers. This i)ri)\isi()n was adopted by
Massachusetts on the advice of the specialists in these fields and
its wisdom has been demonstrated by extensive experience in
that state.

5. Provision that the school physicians may conduct examina-
tions of teachers and janitors and shall make regular inspections
of the buildings, premises and drinking water to insure their
sanitary condition.

6. Provision that pupils in Normal Schools shall receive train-
ing in conducting vision and hearing tests. This requirement
is found in the Massachusetts law and the Minnesota regulations.

7. Provision for the employment of school nurses. This is
provided for in the laws of Connecticut, Ohio, Pennsylvania, and
West \'irs.,Mnia.

8. Provision for the enforcement of the law. Such provisions,
not very well developed, are found in the laws of Colorado,
Indiana and New Jersey. The nature of the provision must
vary with local conditions. In states where municipalities re-
ceive a large part of their school funds from the state, and their
school policies are consequently largely controlled through the
State Board of Education, it seems clear that the enforcement of
the law should be placed in the hands of that body.



California

An Act to Provide for Health and Development

Supervision in the Public Schools of the State

OF California

[Approved April 15, 1909]

The People of the State of California, represented in senate and
assembly, do enact as follows:

HEALTH AND DEVELOPMENT SUPERVISION
Section i . Boards of school trustees and city boards of educa-
tion are hereby authorized to establish health and development
supervision in the public schools of this state, and to employ



13

an examining staff and other employees necessary to carry on
said work and to fix the compensation for the same. Whenever
practicable the examining staff for health and development
supervision in the public schools of the state shall consist of both
educators and physicians.

Sec. 2. The purposes of health and development supervision
in the public schools of the state are hereby defined as follows:

1. To secure the correction of developmental and acquired
defects of both pupils and teachers which interfere with health,
growth and efficiency, by complete physical examination. Said
examinations shall occur annually or as often as may be deter-
mined by the board of school trustees or city board of education.

2. To adjust school activities to health and growth needs and
to development processes and to attend to all matters pertain-
ing to school hygiene.

3. To bring about a special study of mental retardation and
deviation of pupils in the public schools.

Sec. 3. The requirements for certification of members of the
examining staff for health and development supervision in the
public schools of the state shall be as follows:

For educators: A life diploma of California of the high school
or grammar school grade and a health and development certificate
which shall authorize the holder of such certificate to conduct
the work authorized by this act, in those grades specified by the
life diploma held.

For physicians: A California certificate to practice medicine
and surgery and a health and development certificate.

Sec. 4. County or city and county boards of education are
hereby authorized to grant health and development certificates
to holders of life diplomas of California of the high school or
grammar school grade or to holders of California certificates
to practice medicine and surgery who shall present with such
life diplomas or with such certificates to practice medicine and
surgery a recommendation from the state board of education
certifying special fitness for the work specified in this act.



14



Colorado

An Act Providinc; for thk Exa^mination and Care of Chil-
dren IN THH Public Schools, and Making an Appro-
priation IN Connection Therewith

[Enacted 1909]

Be it Enacted by the General Assembly of the State oj Colorado:

Si:ctu)N i. The State Superintendent of Public Instruction
shall prepare or cause to be prepared suitable test cards, blanks,
record books, and other needful appliances and supplies to be
used in testing the sight, hearing and breathing of pupils in the
public schools, and the necessary instructions for their use;
and shall furnish the same free of expense to every public school
in the State. The teacher or principal in every public school,
or where there is no principal, the county superintendent, shall,
during the first month of each school year, test the sight, hearing
and breathing of all pupils under his charge; such examination
to be made by observation, without using drugs or instruments,
and without coming in contact with said child; and keep a
record of such examinations according to the instructions furnished
and make a written report of such examinations to the State
Superintendent of Public Instruction as he may require.

Sec. 2. Every teacher in the public schools shall report the
mental, moral and physical defectiveness of any child under
his supervision, as soon as such defectiveness is apparent, to the
principal or, where there is no principal, to the county superin-
tendent. Such principal or county superintendent shall promptly
notify the parents or guardian of each child found to be defective,
of the child's defectiveness, and shall recommend to such parents
or guardian that such child be thoroughly examined as soon as
possible by a competent physician or surgeon with special refer-
ence to the eyes, ears, nose, throat, teeth and spine.

If the parents or guardian of such child shall fail, neglect or
refuse to have such examination made and treatment begun
within a reasonable time after such notice has been given, the
said principal or superintendent shall notify the State Bureau
of Child and Animal Protection of the facts; Providing, however,
that whenever it shall be made to appear to the said principal
or superintendent, upon the written statement of the parent or
guardian of said child, that such parent or guardian has not



15

the necessary funds wherewith to pay the expenses of such
examination and treatment, the said principal or superintendent
shall cause such examination and treatment to be made by the
county physician of the district wherein said child resides; and
it shall be the duty of such county physician to make such ex-
amination and treatment, and if he be unable to properly treat
such child he shall forthwith report such fact to the county
commissioners of the county with his recommendation.

Sec. 3. The State Auditor is hereby directed to draw his order
for such sums and at such times as the State Superintendent
of Public Instruction may require to carry out the provisions of
this act. The total expenses under this act shall not exceed
one thousand ($1,000.00) dollars in any biennial period ending
November 30.



Connecticut

Chapter XXI. — Health, Sanitation, and Safety

General Statutes, Chapter 131, page 563
[Enacted 1907]

Sec. 2QS. The board of school visitors, board of education, 1907 ch 207 ?i

. . Appointment of

or town school committee of any town, or the board of educa- school

physicians

tion or committee of any school district, may appomt one or
more school physicians and assign one to any public school
within the limits of such town or school district, and shall pro-
vide such school physicians, when so appointed, with proper
facilities for the performance of their duties.

Sec. 294. Every school physician so appointed shall make 1907 ch 207 I2
a. prompt examination of all children referred to him as here-
inafter provided, and such further examination of teachers,
janitors, and school buildings as in his opinion the protection
of the health of the pupils may require.

Sec. 295. The superintendent, principal, or teacher of any '""['^^ ^°'' P
school to which a school physician has been assigned as herein- referred to phy-

. . . . sicians for

before provided shall refer to such physician every child return- examination
ing to school without a permit from the health officer or board
of health, after absence on account of illness or from unknown
cause, and every child attending such school who appears to be
in ill health, or is suspected to be sick with any contagious
or infectious disease, unless such child be immediately excluded



1 6

fnnu siii'li school iiikKt tlie iM-o\isioiis of die general statutes
or the sanitar\' regulations in force in said town or district;
pro\ided, that in the case of schools in remote and isolated loca-
tions the schm)l committee may make such other arrangements
as may he advisable to carry out the purposes of this act.
AwJuIi'eMm-''' ^'■•^"- ^^>^'- ^^^^' school authorities of any town or school dis-
ISuw?^"' trici which has ajipointed a school physician in accordance with

the pro\isions of this act shall cause every child attending the
public schools therein to be separately and carefully tested and
examined at least once in every school \ear to ascertain whether
such child is suffering from defective sight or hearing, or from
any other physical disability tending to prevent such child from
receiving the full benefit of school work, or requiring a modi-
fication of such school work in order to prevent injury to the
child or to secure the best educational results.
1907 ch 207 55 Sec. 297. Notice of the disease or defects, if any, from which

Notict of dis- -" .

ease to be civen any child is found bv such school physician to be suffering shall be

to parent or •' - f ^ o ^

guardian given to the parent or guardian of such child with such advice

or order relating thereto as said physician may deem advisable,
and whenever any child shows symptoms of any contagious
or infectious disease notice shall also be given to the health
ofificer or board of health and such child may be excluded from
attendance at such school in accordance with the provisions of
the general statutes or the sanitary regulations in force in
the town or district.
A?ii>immeJt of ^^^- ^9^- ^Vhenever the board of school visitors, board of
aune^°^ education, or town school committee of any town, or the board

of education or district committee of any school district, shall
have appointed a school physician as provided in Sec. 293, said
board or committee may also appoint a matron or nurse who
shall take such action, under the direction of the school physi-
cian, as may be necessary for safeguarding the health of the
pupils and teachers of the schools. Such matron or nurse shall
also act, under the direction of the school physician, as a visit-
ing nurse in the town or school district, shall visit the homes
of pupils in the public schools, and shall assist in executing the
orders of the school physician.
E^tit^'hlw' Sec. 299. The expenses incurred under the provisions of this
^^ act shall be paid in the same manner as are the ordinary expenses

for the support of schools in the several towns and school dis-
tricts.



17



District of Columbia

Regulations Governing the Medical Inspection of Public

Schools

Promulgated in accordance with an Act making appropriations
to provide for the expenses of the Government of the District of
Columbia, approved March 3, 1903.

Formulated by the Health Officer, June 30, 1903.

Approved by the Board of Education, June 30, 1903.

Approved by the Commissioners of the District of Columbia,
July 14, 1903.

Amended by the Health Officer, July 7, 1907.


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Online LibraryLeonard Porter AyresMedical inspection legislation → online text (page 1 of 5)