WSR 02-15-162

PROPOSED RULES

DEPARTMENT OF HEALTH


[ Filed July 23, 2002, 2:17 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 99-11-031.

Title of Rule: Chapter 246-762 WAC, Scoliosis screening -- School districts.

Purpose: These rules require public schools to screen all students for scoliosis in grades five, seven and nine, with limited exceptions. Screening program requirements are established for program personnel, screening standards, record keeping and notification to parents/guardians.

Other Identifying Information: These rules have been reviewed in conformance with Executive Order 97-02, regulatory improvement. The State Board of Health delegated the adoption of these rules to the department at its October 2001 board meeting.

Statutory Authority for Adoption: RCW 28A.210.200.

Statute Being Implemented: RCW 28A.210.200.

Summary: The proposed changes are limited to housekeeping. Language is updated to be consistent with current standards of rule writing. No changes are proposed in the frequency of screening or screening tests.

Reasons Supporting Proposal: The proposed changes are consistent with the requirements of Executive Order 97-02, regulatory improvement.

Name of Agency Personnel Responsible for Drafting: Frank Chestnut, Department of Health, Mailstop 47880, Olympia, Washington 98504-7880, (360) 236-3574; Implementation and Enforcement: Gayle Thronson, Office of Superintendent of Public Instruction, Mailstop 47200, Olympia, Washington 98504-7200, (360) 725-6040.

Name of Proponent: Department of Health, governmental.

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: The proposed rule changes are housekeeping in nature. The changes improve clarity and readability.

Proposal Changes the Following Existing Rules: Editorial changes are made throughout the chapter, improve the clarity of the rules and do not change the substance of the regulation.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The agency has not completed a small business economic impact statement under RCW 19.85.030. The proposed rule makes changes that are only housekeeping in nature and does not impose additional costs on small businesses.

RCW 34.05.328 does not apply to this rule adoption. The proposed rule makes changes that are only housekeeping in nature. The proposal does not impose penalties, does not set qualifications for licensure or permits, and does not significantly alter policy or regulatory programs.

Hearing Location: Department of Health, CenterPoint Office, 20435 72nd Avenue South, Suite 200, Large Conference Room 1, Kent, WA 98032, on August 27, 2002, at 10:30 a.m.

Assistance for Persons with Disabilities: Contact Frank Chestnut by August 9, 2002, so arrangements can be made, TDD (800) 833-6388, or (360) 236-3574.

Submit Written Comments to: Frank Chestnut, Office of Maternal and Child Health, Department of Health, Mailstop 47880, Olympia, Washington 98504, fax (360) 586-7868, by August 27, 2002.

Date of Intended Adoption: September 3, 2002.

July 19, 2002

M. C. Selecky

Secretary

OTS-5401.4


AMENDATORY SECTION(Amending Order 124B, filed 12/27/90, effective 1/31/91)

WAC 246-762-001   ((Declaration of purpose.)) What is the purpose of scoliosis screening in public schools?   ((The following rules are adopted pursuant to chapter 28A.31 RCW, wherein is contained the mandate that the superintendent of public instruction shall provide for and require screening for scoliosis of school children in the state of Washington. It is the purpose of such screening to identify those children who may have a lateral curvature of the spine.)) The purpose of scoliosis screening in public schools is early detection and notification of parents and guardians about the condition and the need for referral for early diagnosis and possible treatment.

[Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-762-001, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.134 and 43.20.050. 85-23-029 (Order 294), 248-150-010, filed 11/14/85. Statutory Authority: RCW 43.20.050. 79-11-103 (Order 189), 248-150-010, filed 10/31/79.]


AMENDATORY SECTION(Amending Order 249B, filed 3/3/92, effective 4/3/92)

WAC 246-762-010   ((Examinations of school children for scoliosis -- Definitions.)) What words and terms are defined for this chapter?   (1) "Proper training" means instruction and training appropriate for persons who perform scoliosis screening procedures. Proper training is provided by, or under the supervision of, a physician((s)) licensed ((pursuant to)) under chapters 18.57 or 18.71 RCW ((specializing in orthopedic, physiatric, or rehabilitative medicine)), or a registered nurse licensed ((pursuant to)) under chapter 18.79 RCW ((18.88.130)) who has had specialty training in scoliosis detection((, and appropriate for persons who perform the screening procedures referred to in WAC 246-762-040)).

(2) (("Pupil" means a student enrolled in the public school system in the state.

(3))) "Public schools" means common schools referred to in Article IX of the state Constitution and those schools and institutions of learning having a curriculum below the college or university level ((as now or may be)) established by law and maintained at public expense.

(((4))) (3) "Qualified licensed health practitioners" means physicians licensed ((pursuant to)) under chapters 18.57 and 18.71 RCW, registered nurses licensed ((pursuant to)) under chapter 18.79 RCW ((18.88.130)), and physical therapists licensed ((pursuant to)) under chapter 18.74 RCW, practicing within the scope of their field as defined by the appropriate regulatory authority.

(((5))) (4) "Scoliosis" includes idiopathic scoliosis and kyphosis. "Idiopathic" means "of unknown origin." "Scoliosis" means "an appreciable lateral deviation in the normally straight vertical line of the spine as viewed from the back." "Kyphosis" means "an abnormally increased convexity in the curvature of the thoracic spine as viewed from the side."

(((6))) (5) "Screening" means a procedure ((to be)) performed for the purpose of detecting the possible presence of ((the condition known as)) scoliosis, except as provided for in WAC 246-762-070.

(((7))) (6) "Superintendent" means the superintendent of public instruction ((pursuant to)) under Article III of the state Constitution or his or her designee.

[Statutory Authority: RCW 28A.210.200 and [28A.210].220. 92-06-067 (Order 249B), 246-762-010, filed 3/3/92, effective 4/3/92. Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-762-010, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.134 and 43.20.050. 85-23-029 (Order 294), 248-150-020, filed 11/14/85. Statutory Authority: RCW 43.20.050. 79-11-103 (Order 189), 248-150-020, filed 10/31/79.]


AMENDATORY SECTION(Amending Order 249B, filed 3/3/92, effective 4/3/92)

WAC 246-762-020   ((Criteria for selection of children for scoliosis screening.)) When are students screened for scoliosis?   Each public school shall annually screen all ((children)) students in grades five, seven, and nine ((shall be screened annually except as provided for in RCW 28A.210.240)) except students with a valid written exemption request from a parent or guardian. Valid exemption requests must certify scoliosis screening conflicts with philosophical or religious beliefs or the student is under the care of a health care provider for spinal curvature or a related medical condition.

[Statutory Authority: RCW 28A.210.200 and [28A.210].220. 92-06-067 (Order 249B), 246-762-020, filed 3/3/92, effective 4/3/92. Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-762-020, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.134 and 43.20.050. 85-23-029 (Order 294), 248-150-030, filed 11/14/85. Statutory Authority: RCW 43.20.050. 79-11-103 (Order 189), 248-150-030, filed 10/31/79.]


AMENDATORY SECTION(Amending Order 124B, filed 12/27/90, effective 1/31/91)

WAC 246-762-030   ((Qualification of personnel.)) What are the qualifications for persons who do screening?   (1) ((Screening shall be conducted by school physicians, school nurses, qualified licensed health practitioners, physical education instructors, other school personnel, or persons designated by school authorities who have received proper training in screening techniques for scoliosis.)) Persons who screen for scoliosis must be school physicians, school nurses, qualified licensed health practitioners, physical education instructors, other school personnel, or other persons designated by school authorities who have received proper training.

(2) Each school district shall designate one individual of the district's staff who ((shall be)) is responsible for the administration of scoliosis screening. This individual's training and experience ((shall)) must be appropriate to perform the following tasks:

(a) ((To)) Develop an administrative plan for conducting scoliosis screening in the district in cooperation with the appropriate school personnel ((in order to)). The plan must ensure the program can be carried out efficiently with minimum disruption, ((to)) and include arrangement of appropriate scheduling for scoliosis screenings;

(b) ((To)) Secure appropriate personnel with proper training to carry out the screening program ((and to ensure such personnel receive proper training to conduct the necessary screening procedures));

(c) ((To)) Ensure accurate and appropriate ((records are made, to)) recordkeeping, make recommendations appropriate to the needs of each ((child)) student whose screening test is indicative of possible scoliosis, and ((to)) provide copies of these records to parents or legal guardians of ((the child, as provided for in section 4, chapter 216, Laws of 1985)) each student; and

(d) ((To)) Disseminate information to other school personnel ((explaining)) to explain the purpose of the program, and to ((acquaint them with)) inform them of the criteria which might ((denote)) indicate the need for referral for scoliosis screening; and

(e) To institute a procedure to evaluate the effectiveness and accuracy of the screening program.

[Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-762-030, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.134 and 43.20.050. 85-23-029 (Order 294), 248-150-040, filed 11/14/85. Statutory Authority: RCW 43.20.050. 79-11-103 (Order 189), 248-150-040, filed 10/31/79.]


AMENDATORY SECTION(Amending Order 249B, filed 3/3/92, effective 4/3/92)

WAC 246-762-040   ((Screening procedures.)) What are the medical standards for screening?   The screening procedures ((shall)) must be consistent with nationally accepted standards for scoliosis screening and published by the American Academy of Orthopedic Surgeons as contained in Screening Procedure Guidelines((, to)) for Spinal Deformity. These guidelines may be obtained from the Scoliosis Research Society.

[Statutory Authority: RCW 28A.210.200 and [28A.210].220. 92-06-067 (Order 249B), 246-762-040, filed 3/3/92, effective 4/3/92. Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-762-040, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.134 and 43.20.050. 85-23-029 (Order 294), 248-150-050, filed 11/14/85. Statutory Authority: RCW 43.20.050. 79-11-103 (Order 189), 248-150-050, filed 10/31/79.]


AMENDATORY SECTION(Amending Order 124B, filed 12/27/90, effective 1/31/91)

WAC 246-762-050   ((Screening results -- Recording and referral procedures.)) What happens to screening results?   ((A record of the "screening" results shall be made of each child suspected of having scoliosis and copies of the results shall be sent to the parents or guardians of the children.)) The school shall create a record of screening results for each student suspected of having scoliosis, and shall notify the parent or legal guardian of the student. The notification ((shall)) must include an explanation of scoliosis, the significance of treating scoliosis at an early stage, the services generally available from a qualified licensed health practitioner for treatment after diagnosis, and a method for the school to receive follow-up information from health care providers.

[Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-762-050, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.134 and 43.20.050. 85-23-029 (Order 294), 248-150-060, filed 11/14/85. Statutory Authority: RCW 43.20.050. 79-11-103 (Order 189), 248-15-060 (codified as WAC 248-150-060), filed 10/31/79.]

Washington State Code Reviser's Office