StudentWeightStatusCategoryReporting

Frequently AskedQuestions

Whatdoes the law require?

Education Law Sections 903 and 904 require a system to assess the prevalence of childhood obesity throughout New York State. In addition, Regulations 136of the CommissionerofEducationrequireahealthcertificate (completed by the private provider)orahealth appraisal (completed by the district medical director)for studentsat schoolentry (pre-Kor K),andin grades2, 4,7and10. The health certificate or health appraisal must include an assessment of Body Mass Index (BMI) and weight status (based on BMI-for-age percentile).This information is used to report data to the NYSDOH to assess childhood obesity in NYS.

How is BMI and WSC data collected?

Each year, a 50% sample of public school districts (excluding those in the five boroughs of NYC which are exempt from NYS Education Law Sections 903 and 904) is notified that they have been selected to report aggregated student weight status category and health conditions information to the NYSDOH electronically, using the Health Commerce System (HCS). If schools wish to voluntarily report during a year they are not selected they may do so. Voluntary reporting during an academic year a school is not selected to participate in the survey does not exempt the school from reporting during the year the school is selected and required to participate in the survey.School staff,predominantlyschool nurses,aggregatethenumbersofstudentsin the following six weight status categoriesbasedonsex-specificBMI-for-agepercentiles:

  • Less than 5th percentile
  • 5th to49thpercentile
  • 50th to84thpercentile
  • 85thto94thpercentile
  • 95th to 98thpercentile
  • 99thandabove

Whatis theHealthCommerce System(HCS) andhowdowe get accounts?

TheHCSis a secureinternetsite which allows confidentialdatatobesent totheNYSDOHelectronically. TousetheHCS,aschooldistrictmust create an account to enter andsubmitthedata tothe NYSDOH.Accounts may be set up on-line. Account set up information is available on the New York State Center for School Health (NYSCSH) website:

Note:School staffthathasusedtheHCStosubmitimmunization,absenteeismor studentweight statuscategoryshould usethesameaccount.

At what grade levels is BMI/WSC health data collected?

Data is collected from health examination forms (certificates/appraisals)providedto theschoolin thePREVIOUSschoolyear.Formsfor studentssubmitted when studentswereingrades

Pre-K/K, 2,4,7and10 are used as the documentation for students currently in currently in grades 1, 3, 5, 8 and 11.Schools will be required to report aggregated student weight status category data for either pre-Kindergarten or Kindergarten based on a student’s official school entry and student number assignment.If students attended Pre-K in the previous year, the mandated exam form from Pre-K would be used to report for those students currently in Kindergarten.Additional information on how to report Pre-K/K students is available on the New York State Center for School Health (NYSCSH) website:

Is there a formor an electronic filetotallythenumberof studentsin eachofthe weight status categories?Cantallyingbedoneasforms arereceivedorphysicalsareperformedratherthanretrievingfilesto tallybyafter notification that our district was selected?

TheState HealthDepartmentdevelopedinstructionsand reference materialsincluding toolsfor schoolstaff to tallythenumber ofstudentsineach weightstatus categorybygradegroup andsex,the numberofstudentsin the99thandgreater BMI-for-agepercentile,andwitheach healthcondition.Thesetools canbeused as individualhealthcertificateformsarereceived, asappraisalexaminationsare conducted, or afterallschoolphysicalshavebeen completed.Instructionsandreference materialsare available on theNew York State Center for School Health (NYSCSH) website:

It may be helpful to districts to tally all physical examinations as they are received so that the data is available if needed. This data may also be used internally to monitor health and wellness at the district level.

How is the data reported to NYSDOH?

Each school district must identify who will report data for the entire district (known as the School District Nurse or Coordinator) and assign them that role in their HCS account. Building level data is senttothe SchoolDistrictNursecoordinator who then combines or aggregates thedata andreports it for theentireschooldistrict on the HCS.Studentweightstatuscategoryandhealthconditionsdataneedto becombinedbythreegradegroupsfor allschoolsintheschooldistrict.The three gradegroupsare Pre-K, K,2and 4, 7and10 and District Totals. Student Weight StatusCategorySurvey, datashouldbereportedbygradegroupandsex. HealthConditionsSurveydatawill needtobereported bygradegrouponly.

Is there a recommended Health Examination form my district could use?

ArecommendedStudentHealth Examinationform is included as part of the 2013 NYSED Health Examination Guidelines. It is available from the New York State Center for School Health (NYSCSH) website:

Providers and districts may use any form which includes BMI and the weight status category information. Collection of information regarding health conditions, if known, is also encouraged but is not required by law.

Howare physiciansandotherhealthcare providersinformed about the requirement?

AllNYS-licensedpediatricians,familymedicinephysicians,pediatric and familymedicineresidents,pediatricand familynursepractitionersand healthcareproviders at school-basedhealth centerswerenotified bymail when the amendment was enacted in 2007.

What should we do if the requiredhealthexaminationsare performedby theschoolmedicaldirector?

For health examinationsperformed at school,BMI canbecalculatedfromastudent’sheightandweightusing aBMIcalculator wheel or computer program.Weightstatuscategoryisdetermined byplotting theBMIonasex-specificBMI-for-agepercentile growthchart. ForfreeBMIcalculator wheelsand/or BMIpercentilegrowthchartsplease or download theorderformavailable at:

Whatis thenurses’rolein calculatingBodyMassIndex (BMI) anddeterminingweight status category(basedonBMI-for-agepercentile)?

Onlyastudent’shealthcare provider mayperform andcomplete ahealthcertificate and only the school medical director can perform and complete the health appraisal at school.A school medicaldirector maywrite apolicystating thattheschoolnursesinhis/her districtcanperformthe heightandweightmeasurement,calculatetheBMIand determinetheweightstatus category.Theschoolnurse may thendocumenttheseon thehealthcertificate formforthe provider ifrequested. However, itis theresponsibilityof the medicaldirector to interpretthe weight status category and whateffectitmayhaveon thestudent’shealth. Bysigning thehealth appraisalform, the medicaldirector istaking responsibilityfortheinformationonthe form and isensuring thatanyidentifiedhealth problemsare reported tothe parentto arrange forfollow-up.

What happensifa student’sprivatehealthcareproviderdoesn’t returntheformorifitisincomplete?Who is responsiblefordeterminingBMIandweight statuscategory?

A health certificate completed by a private healthcare provider must include the BMI and weight status category information. A school nurse may not just fill in the missing BMI and weight status category information.

  • If theparentfails to providetherequired healthcertificate,theinformationshouldbeaddedaspartoftheschoolhealth appraisalconductedunder localdistrictpolicy. If thehealth certificateisincomplete,itwouldbe advisable for theschoolnursetoreturnacopyofthe formtothe familyfor the family’sprivatehealthcareprovider tocomplete.
  • If thehealth certificate is not returnedor isreturned butdoesnotcontaintheweight statuscategory,thenthestudent’sweight statuscategoryshould betalliedunderthe “missing” category.

Is therebe a sample notificationourschoolcansendtoparents/guardians to inform themabout thereporting requirement?

Yes. Sample parentalnotificationlanguagehasbeen developedandisavailablefromtheNew York State Center for School Health (NYSCSH)website:

Schoolsmayprovidenoticetoparentsviathe schoolnewsletter,website,thepre-Kindergartenor Kindergartenregistration packet,and/or other reasonablemeans.

Doesthelegislationrequirethat BMIorweight statusdatabe reportedtoparents/guardians?

Thelegislation doesnotrequirereporting ofBMI or weight status categorytoparents/guardians. BMI andweightstatuscategoryaretobeaddedtotheStudentHealth Certificate/Appraisalrequired byNewYork StateEducationLawSections903and 904.It istheresponsibilityofthehealthcare provider whoconductsthe healthexamination tointerprettheweight statuscategoryfor eachstudentand his/her parents/guardiansas partofroutine preventivecare,andtoprovidecounseling,follow-upandreferral as indicated.

Howshouldparents/guardiansbeinformed ifa weight issueisidentifiedduring ahealthexaminationat school?

If aconcern aboutastudent’sweight status isidentifiedduring thehealthexaminationperformed at school,itshouldbe handledin thesame manner asotherhealthconcernsidentifiedduring the healthappraisal.

Should I count a student ashaving ahealthcondition if medication isadministeredforthecondition,eventhoughthediagnosisisnot documentedonthehealthcertificate/appraisalorcumulativehealthrecord?

No,onlyalicensed healthcare provider (physician,PA, or nursepractitioner) candiagnose.Aschoolnurseor other schoolpersonnelcannotdiagnoseandthereforecannotassume thereasona medication hasbeenprescribed,asmanyareused for multiple diagnoses.If theinformationisnotprovidedonthehealth certificate or health appraisal,withthe parent/guardianhaving signedpermission tohavethe informationprovidedtotheschool,itshould not bereleasedeveninredacted form. Additionally, theoriginaldiagnosisthatisinthehealth record maybeinaccurateornolonger anactivehealth problemforthatstudent.

If the electronichealthrecordsystemautomaticallycalculates theBMIpercentileonceheight andweight isentered, may that number be used or must the BMIpercentileweight statuscategoriesrecordedbyphysiciansbe used?

Thelawrequires thattheBMIandweightstatuscategoryreportedare fromthehealthcertificateorappraisal. Astudent’shealthappraisalisperformed bytheschool’smedicaldirector,andthe medicaldirectormaydetermine howtheBMIandweightstatuscategoryarecalculated.Ahealthcertificate from aprivatehealthcare provider cannotbe added toor alteredbytheschool. Available on New York State Center for School Health (NYSCSH) website: Click here to view Attachment A

WhyareBMIandweight status measurement important?

Obesityprevalencedataofschool-agechildrenand adolescents atthelocaland statelevel isusedto understand the severityanddistribution ofobesityamong youth ofvariousagesindifferentregionsofthestate.Thisis acriticalfirst stepintargeting resourcesfor childhood obesitypreventionto high-riskcommunities. Theinformationisalsousedtoevaluate whether actionstaken bylocalschools,schooldistricts and communitiestoimproveaccessto healthyfoodsandtoincreasephysicalactivityaremakinga differenceandreducing childhoodobesityrate.

Whatis theefficacyof BMI?

BodyMassIndex(BMI)-for-agepercentilesarethestandard method usedtoscreen for childhood obesity, as recommendedbytheCentersforDiseaseControlandPrevention, the American Academyof PediatricsandtheAmericanAcademyofFamilyPhysicians. Anumber ofstudieshavedeterminedthattheBMI-for-agepercentileis areliableandvalidindicator ofbodyfatnessinchildren and adolescents. Furthermore,BMI-for agepercentileshavebeenshowntobe moresensitiveandspecificindeterminingboth overweight and underweightinchildren andadolescentsthanweight-for-ageor height-for-agepercentiles.Their use alsofacilitatesthe earlyrecognitionofexcessiveweightgain.Currentrecommendationscallfor BMI-for-agepercentilestobeusedasa“screening tool,”nota diagnostictest.Anindividualchildidentified witheitherhighor lowBMIpercentilesshouldundergo further assessment.

Whydo I receivetheerrormessage,“Fieldvaluecannot belessthan 5,”ontheWeight Status CategorySurveyortheHealthConditionsSurvey?

Youwillreceivetheaboveerror messageifyouentera0,1,2,3or4inany oftheweightstatuscategoryor obesity-relatedhealthconditionsfields.Ifthenumberofstudentsin aweight status categoryor healthcondition fieldislessthanfive,youmustleavethefield blank. Numbersinthese fieldsmustbegreater thanorequalto fivetoprotectstudentconfidentialityandto maintaincompliancewiththe federalFamilyEducationalRights and Privacy Act (FERPA).

Numberslessthan five canbereported forthe following fieldson theWeightStatusCategorySurvey:

  • “Totalnumber ofstudentsenrolledin thisgroup”
  • “Numberofboys or girlsmissing information”
  • “Numberofparentsrequesting their child’sdata be excluded forthisgroup.

Where can I find Student Weight data once it is released from NYSDOH?

Student Weight data is available on Health Data NY, the state’s open data website devoted solely to health data. Estimates of overweight and obesity for public school students outside of New York City are available at the school district, county, regional and statewide level. The tabular dataset, school district obesity map, and graphs of statewide, county and regional obesity prevalence are availablehere. Click on the purple “More Views” button to view all of the Student Weight data visualizations.