Revised Health Services Rule Adopted by State Board

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Oregon Department of Education - Oregon achieves - together

To: Superintendents, Communicable Disease Preparedness Liaisons, Charter School Leaders, Principals, School Nurses, K-12 Public Information Officers 
From: Kati Moseley; Administrator, Health in Education  
Date: June 23, 2023 
Re: Revised Health Services Rule Adopted by State Board 

Dear Colleagues, 

Thank you for another successful school year in supporting student and staff health and wellness. As we move into the summer months, we reflect upon the importance of promoting, protecting, and responding to student health needs while planning for the upcoming academic year. 

We are excited to share that the long standing Health Services Rule (OAR 581-022-2220) was updated and adopted by the State Board of Education on Thursday, June 15th. Recognizing the importance of health in supporting equitable and well-rounded education for every student in Oregon, this rule seeks to promote the health and safety of all students across the state.    

This update incorporates learning from the last three years of school operations and brings the rule into alignment with current statute and rules.  

The revised rule: 

  • Requires school districts, public charter schools and education service districts to have a prevention-oriented health services plan for all students; 
  • Clarifies existing expectations for schools related to communicable disease management; 
  • Requires the provision of comprehensive, medically accurate, and inclusive health-related services for students, when schools contract for such services; and 
  • Clarifies requirements related to nursing and delegation in alignment with state statutes and rules. 

The rule also maintains long existing state standards for health screenings and immunizations; vision, hearing, and dental screenings; bloodborne pathogen exposures; medication administration; emergency medication management; and first-aid trained staff-to-student ratio requirements. 

The communicable disease planning expectations of the rule align with the school-level communicable disease planning released by ODE on May 10, 2023. Districts, public charter schools, and education service districts are still required to submit assurances regarding school-level communicable disease planning for the 2023-24 school year as specified in that communication.  


OAR 581-022-2220 was created in 1980; it was last revised in 1996 and renumbered in 2017. In response to the learning and experiences from the past three years, ODE sought to codify this knowledge and clarify expectations to support student health through the work of the Health in Education team and the Office of Enhancing Student Opportunities. ODE engaged with districts, ESDs, and educational and health partnerships across Oregon in updating the rule.  

Implementation and Next Steps 

The revised rule will be effective for the 2023-2024 academic year. Districts will report on their compliance as part of Division 22 annual reporting. ODE staff will provide templates, tools, technical assistance, and other supports for the implementation of the rule in the coming months.  

Please email any questions to ODE’s support inbox,