check
Administration of Medications

Alaska

Last Updated: 10/13/2013

Staff Administration: 12 AAC 44.965 allows school nurses to delegate administration of medications to a school setting provider; defined as a person who is employed at a school that provides educational services to students age 21 or younger. The person to whom the administration of medication is to be delegated must successfully complete a training course in administration of medication approved by the board. Additional requirements are outlined in the rule. The Medication Administration: Guide for Training Unlicensed School Staff (2012) provides additional guidance.

Self-Administration of Asthma Medication: Statute 14.30.141, per HB 85, (2005) permits public school students to self-administer medication for asthma during the school day if the parent/guardian of the student provides written authorization for the self-administration of medication and releases liability for the school and its employees for any injury resulting from self-administration, and if written certification is provided by the student's health care provider. The law further allows those students self-administering medication to carry and store an inhaler at all times.

Self-Administration of  Anaphylaxis Medication: Statute 14.30.141, per HB 85, (2005) permits public school students to self-administer medication for anaphylaxis during the school day if the parent/guardian of the student provides written authorization for the self-administration of medication and releases liability for the school and its employees for any injury resulting from self-administration, and if written certification is provided by the student's health care provider. The law further allows those students self-administering medication to carry and store an autoinjectable epinephrine at all times.

Psychotropic Medications: Statute 14.30.171 (2006) prohibits school personnel, unless otherwise authorized by law or a specific policy adopted by a governing body of a school district, recommending to a parent or guardian that a child take or continue to take a psychotropic drug as a condition for attending a public school.

Storage and Record-keeping: No state policy.


Alabama

Last Updated: 9/20/2013

Staff Administration: Alabama Board of Nursing Administrative Code 610-X-7.02 (2009) requires a school nurse to be accountable and responsible for the nursing care delivered to students. Administration of prescription medications to a student through twelfth grade may be delegated to unlicensed assistive personnel who has been recognized by the school nurse and has completed a twelve-hour course of instruction. The State Board of Education/Alabama Board of Nursing provides guidance in Curriculum to Teach Unlicensed School Personnel How to Assist with Medications in the School Setting (2003). 

Self-Administration of Asthma Medication: Code 16-1-39 (2007) states that each local board of education shall permit the self-administration of medications for a chronic condition by students if a parent or legal guardian provides written authorization for the self-administration of medication, written authorization from a physician with a signature and confirmation that the student has been properly instructed, and written acknowledgement that the school will incur no liability. If permission is obtained, a student is permitted to possess and self-administer approved  medication at any time while on school property or at a school-sponsored event.

Self-Administration of Anaphylaxis MedicationCode 16-1-39 (2007) states that each local board of education shall permit the self-administration of medications for a chronic condition by students if a parent or legal guardian provides written authorization for the self-administration of medication, written authorization from a physician with a signature and confirmation that the student has been properly instructed, and written acknowledgement that the school will incur no liability. If permission is obtained, a student is permitted to possess and self-administer approved  medication at any time while on school property or at a school-sponsored event.

Storage and Record-keeping:  The State Board of Education/Alabama Board of Nursing Curriculum to Teach Unlicensed School Personnel How to Assist with Medications in the School Setting outlines the responsibilities of school nurses which includes implementing procedures for handling, storing, and disposing of medications. The Curriculum further requires the medication assistant to complete timely, accurate documentation of assistance with medication. Board of Nursing Administrative Code 610-X-7.02 (2009) also requires the school nurse to periodically conduct quality monitoring of tasks performed by unlicensed personnel, including documentation and error reporting when providing nursing care to students.

Psychotropic Medications: The State Board of Education/Alabama Board of Nursing Curriculum to Teach Unlicensed School Personnel How to Assist with Medications in the School Setting allows students with ADHD or other behavioral/emotional/psychosocial disorders to receive assistance in the administration of medications during school. 

Medical Emergencies: The State Board of Education/Alabama Board of Nursing Curriculum to Teach Unlicensed School Personnel How to Assist with Medications in the School Setting requires schools to establish an emergency action plan that include emergency procedures covering on-campus and off-campus occurrences for students with known life-threatening conditions.


Arkansas

Last Updated: 12/28/2013

Staff Administration: No state policy.

Self-Administration of Asthma Medication: Statute 6-18-707 (2005) requires the Department of Education to develop guidelines for school districts to adopt policies that allow students to carry and use prescription asthma inhalers while in school or at school-sponsored activities on or off school property. The guidelines should include procedures for requiring written authorization for one school year from the parent/guardian; medical documentation of health care practitioner's prescription, evidence of the need to carry the inhaler, a copy of an individualized health care plan. If a student does not carry the inhaler on his person, then the parent or guardian shall provide the school with the appropriate medication in case of an emergency. The law further protects a school district and its employees from any liability for injury caused by a student's use of a prescription inhaler or self-administration of medication.

Self-Administration of Anaphylaxis Medication: Statute 6-18-707 (2005) requires the Department of Education to develop guidelines for school districts to adopt policies that allow students to carry and use prescription auto-injectable epinephrine while in school or at school-sponsored activities on or off school property. The guidelines should include procedures for requiring written authorization for one school year from the parent/guardian; ; evidence of the need to carry the auto-injectable epinephrine; and medical documentation of health care practitioner's prescription and a copy of an individualized health care plan. If a student does not carry the auto-injectable epinephrine on his person, then the parent or guardian shall provide the school with the appropriate medication in case of an emergency.The law further protects a school district and its employees from any liability for injury caused by a student's self-administration of medication.

Psychotropic Medication: No state policy.

Storage and Record-keeping: No state policy.


Arizona

Last Updated: 7/18/2013

Staff Administration: ARS 15-344 (2002) gives school districts the responsibility of establishing policies and procedures regarding the administration of prescription medication to students by school employees. In the case of a minor student, administration of medications shall only occur upon the written or oral request or authorization of a parent or legal guardian. ARS 15-344.01 (2008) allows a school district governing board and the charter school governing body may adopt policies and procedures to designate two or more school employees to serve as voluntary diabetes care assistants. Care assistants may intervene if the following conditions have been met: (1) a school nurse or another health professional is not immediately available, (2) the parent or guardian  has provided the school an unexpired glucagon kit prescribed by a health professional, and (3) the volunteer diabetes care assistant has provided the school with a written statement signed by a health professional that the care assistant has received proper training in the administration of glucagon. Training requirements are outlined in the statute. Diabetes care assistants are immune from civil liability for the consequences of the good faith adoption and implementation of policies and procedures pursuant to this section.

Self-Administration of Asthma Medications: ARS 15-341 (2005) requires district governing boards to allow the possession and self-administration of prescription medication for breathing disorders in handheld inhaler devices by pupils who have been prescribed the medication by aa licensed health care professional. The pupil's name on the prescription label on the medication container or on the medication device is sufficient proof that the pupil is entitled to the possession and self-administration of the medication. The statute also provides immunity from civil liability for a school district and its employees with respect to all decisions made and actions taken that are based on good faith implementation of the requirements of this paragraph, except in cases of wanton or wilful neglect.


Self-Administration of Anaphylaxis Medications: ARS 15-341 (2005) requires the board of directors of a school district to prescribe and enforce policies and procedures allowing pupils who have been diagnosed with anaphylaxis by a health care provider to carry and self-admninister emergency medications including auto-injectable epinephrine while at school and at school sponsored activities.The pupil's name on the prescription label on the medication container or on the medication device is sufficient proof that the pupil is entitled to the possession and self-administration of the medication. The statute also provides immunity from civil liability for a school district and its employees with respect to all decisions made and actions taken that are based on good faith implementation of the requirements of this paragraph, except in cases of wanton or wilful neglect.


Psychotropic Medications: No state policy.

Storage and Record-keeping: No state policy.


Last Updated: 7/18/2013
check

Self-Administration of Diabetes Medications: ARS 15-344.01 (2008) allows the school district governing board and the charter school governing body to adopt policies and procedures for pupils who have been diagnosed with diabetes. The policies and procedures shall allow students to manage their diabetes in the classroom, on school grounds and at school sponsored activities. If a school district or charter school adopts policies and procedures, they must include the following components: (1) The parent or guardian must annually submit a diabetes medical management plan to the student's school authorizing them to carry appropriate medications and monitoring equipment, and acknowledging that the pupil is capable of sellf-administration. The management plan must be signed by a licensed health professional; (2) A requirement that the student be able to practice proper safety precautions for the handling and disposal of equipment, and a specified method of disposal; and (3) Procedures that enable a school district or charter school to withdraw a pupil's authorization to monitor blood glucose and self-administer diabetes medication if the student does not practice proper safety precautions. The statute also allows for the training and authorization of voluntary diabetes care assistants.


California

Last Updated: 9/18/2013

Staff Administration: Education Code 49400 (1976) allows school districts to employ properly certified personnel to care for the health and physical development of students. More specifically, Education Code 49423 (1976) and California Code of Regulations Title 5, Division 1, Chapter 2, Subchapter 3, Article 4.1, 600 (2003) and Education Code 49423 (2004) state that any pupil required to take during the regular school day prescribed medication may be assisted by a school nurse or other designated school personnel if the pupil's authorized health care provider and the parent or guardian provide written statements. Details of this regulation are provided in subsequent codes 601-604 of the same article.

Self-Administration of Asthma MedicationEducation Code 49423.1 allows students to carry and self-administer inhaled asthma medication. The student must provide a physician statement detailing the name of the medication, method, amount and time schedules, confirmation of the student's ability to self-administer, a written statement from the parent or guardian, a release for the school nurse and for the school district. These documents must be provided annually. 

Self-Administration of Anaphylaxis Medication
Education Code 49423.1 allows students to carry and self-administer anaphylaxis medication. The student must provide a physician statement detailing the name of the medication, method, amount and time schedules, confirmation of the student's ability to self-administer, a written statement from the parent or guardian, a release for the school nurse and for the school district. These documents must be provided annually. 

Education Code 49414 (2001) allows school districts to utilize epinephrine auto-injectors to provide emergency medical aid to persons suffering from an anaphylactic reaction. According to the code, each public and private elementary and secondary school may voluntarily determine whether or not to make emergency epinephrine auto-injectors and trained personnel available at its school and may designate one or more school personnel to receive initial and annual refresher training.

Self-Administration of Diabetes Medication:  Education Code 49414.5 (2003) allows, in the absence of a credentialed school nurse or other licensed nurse, each school district to provide voluntary emergency medical training to school personnel in how to administer emergency medical assistance to pupils with diabetes suffering from severe hypoglycemia if certain performance standards for training and supervision are developed by the American Diabetes Association in cooperation with several other entities for approval and distribution by the State Department of Health Services' Diabetes Control program. According to the code, pupils who have diabetes and specified authorization to test their blood glucose level and provide diabetes self-care are permitted to do so in any area of the school or school grounds during any school-related activity and, upon the request of the pupil's parent or guardian, in a private location. The California Supreme Court upheld the right of unlicensed school personnel to administer prescription medications as cited in Education Code 49423 and 49423.6, including insulin, in accordance with written statements of individual students, treating physicians, with parental consent and that persons that act under this authority do not violate the Nurse Practice Act. 

K.C. et al. v. Jack O'Connell, et al. (2007) clarifies the rights of students classified as disabled with diabetes. Under the decision, the California Department of Education is required to issue a Legal Advisory to all school districts providing guidance on health care services with diabetes, emphasizing that districts have an obligation to provide insulin administration and related services to students unable to self-administer. The Advisory spells out who may administer insulin at a school, and it requires that the local education agency must provide training in diabetes management to a volunteer, non-licensed staff member in cases when a school nurse or other licensed professional is not available. California Business and Professions Code 2725(b)(2) and the California Code of Regulations Title 5, Division 1, Chapter 2, Subchapter 3, Article 4.1, 604 authorize the following types of persons to administer insulin in California's public schools pursuant to a Section 504 Plan or an IEP: (1) self-administration with parent authorization, (2) licensed nurse, registered nurse or physician, (3) parent, guardian or designee, (4) unlicensed voluntary school employee with appropriate training, (5) voluntary school employee who is unlicensed but who has been adequately trained to administer insulin pursuant to the student's treating physician's orders as required by the Section 504 Plan or the IEP.

Self-Administration of General Medication: California Code of Regulations Title 5, Division 1, Chapter 2, Subchapter 3, Article 4.1, 605 (2003) authorizes the local education agency to establish rules governing self-administration including circumstances when self-administration is prohibited. Education Code 49423.1 (2004) allows a pupil to carry medication and self-administer medication provided appropriate statements from the physician are given. The code further releases the school district and school personnel from civil liability if the student suffers an adverse reaction by taking the medication.

Psychotropic Medications: No specific state policy. Unless specified, general medication in school laws apply to all medications that are prescribed by an authorized health care provider.

Storage and Record-keeping: California Code of Regulations Title 5, Division 1, Chapter 2, Subchapter 3, Article 4.1 606 (2003) allows local education agencies to establish policies the delivery of medications to the school site and the storage of medications in a secure manner that maintains the medications' effectiveness. California Code of Regulations Title 5, Division 1, Chapter 2, Subchapter 3, Article 4.1 607 (2003) allows local education agencies to establish policies addressing documentation of the administration of medication to pupils to ensure pupil confidentiality is maintained, a medication record is maintained, and an appropriate record of the pupils allowed to self-carry and administer medications is kept.


Colorado

Last Updated: 4/29/2012

Staff Administration: Colorado provides guidelines for administration of medication for school districts to follow.

Statute 22-2-135 (2009) requires the State Board of Education to promulgate rules for the management of food allergies and anaphylaxis among students enrolled in public schools. The rules must include the provision of emergency anaphylaxis treatment training for appropriate staff, including self-injectable epinephrine. Statute 22-2-139 (2009) requires each school district board of education to adopt and implement a policy for the management of food allergies and anaphylaxis, in accordance with the rules established by the State Board of Education in Statute 22-2-135 (2009). Statute 22-30.5-518 (2009) requires the state charter school institute to adopt and implement a policy for the management of food allergies and anaphylaxis which at a minimum must satisfy the rules in 22-2-135 (2009) . 

Self-Administration of Asthma Medication:  Statute 22-1-119.5 (2005) allows for a student with asthma to possess and administer medication if the student has a treatment plan approved.This statute requires a prescription from health care practitioner for use during school hours, school-sponsored activities, and while in transit to or from school or school sponsored activities, and that the student have the necessary skill level and be instructed in the proper use of the medication. The school nurse and health care practitioner are required to collaborate to formulate a written treatment plan, renewed annually in the case of a public school, and the student's parent or legal guardian must complete and submit to the public or nonpublic school the required documentation, including written medical authorization, a waiver of liability, and a written contract between the school nurse, the student, and the parent or guardian assigning level of responsibility to the parent or guardian, student, and school employees.

Self-Administration of Anaphylaxis Medication: Statute 22-1-119.5 (2005) allows a student with severe allergies to possess and self-administer medication to treat anaphylaxis if the student has a treatment plan approved. This statute requires that the medication be prescribed by a health care practitioner for use during school hours, school-sponsored activities, and while in transit to or from school or school sponsored activities, and that the student have the necessary skill level and be instructed in the proper use of the medication.

The school nurse and health care practitioner must also collaborate to formulate a written treatment plan, renewed annually in the case of a public school, and the student's parent or legal guardian must complete and submit to the public or nonpublic school the required documentation, including written medical authorization, a waiver of liability, and a written contract between the school nurse, the student, and the parent or guardian assigning level of responsibility to the parent or guardian, student, and school employees.

Psychotropic Medications: Statute 22-32-109 (2003) requires the board of education to adopt a policy to prohibit school personnel from recommending or requiring the use of a psychotropic drug for any student".

Storage and Record-keeping: Medication Administration in the Schools states that "school health personnel should maintain accurate individualized daily records of medications administered, any special circumstances related to the procedure, and the student's unusual reactions or responses. A separate medication log must be kept for each student. This log becomes a permanent record and provides legal protection to those who administer medications in schools". All medications should be locked and stored in drawers, refrigerators, or cabinets for that purpose. Emergency medications should be stored in a secure area inaccessible to children. The medication must be immediately available to personnel at all times students are present.

Statute 22-1-119.5 (2005) allows schools, with the approval of a parent or legal guardian with a student an approved treatment plan, to maintain additional asthma or anaphylaxis medications in a location where the student must have immediate access in the event of an asthma or anaphylaxis emergency.


Connecticut

Last Updated: 10/25/2011

Staff Administration: Public Health Code 10-212a (2009) allows a school nurse or, in the absence of such nurse, any other licensed nurse who shall administer medicines only to students enrolled in a school-based health clinic in the absence of a school nurse, the principal, any teacher, licensed athletic trainer, licensed physical or occupational therapist employed by a school district, or coach of intramural and interscholastic athletics of a school may administer prescribed medicinal preparations. The administration of medicines by any of the aforementioned employees must be under the general supervision of a school nurse. The statute also provides for immunity from liability for those administering medicines, with the exception of omissions of gross, willful or wanton negligence. It requires the State Board of Education to adopt regulations specifying (1) the conditions under which a coach of intramural and interscholastic athletics may administer medicines to a participating child and (2) conditions and procedures for the administration of medication by school personnel to students

Statute Section 10-212a-10 (2010) allows for the administration of a cartridge injector medication by a director or director’s designee, lead teacher or school administrator for school readiness programs and before- and after-school programs, only to a student with a medically-diagnosed allergic condition which may require prompt treatment to protect the student against serious harm or death.

Details of these statutes can be found in the Regulations for the Administration of Medications by School Personnel and Administration of Medication During Before- and After-School Programs and School Readiness Programs.

Self-Administration of Asthma MedicationThe Regulations for the Administration of Medications by School Personnel and Administration of Medication During Before- and After-School Programs and School Readiness Programs, Connecticut General Statutes Section 10-212a-4 requires that “in the case of inhalers for asthma…students may self-administer medication with only the written authorization of an authorized prescriber and written authorization from a student’s parent or guardian or eligible student.”

Self-Administration of Anaphylaxis MedicationThe Regulations for the Administration of Medications by School Personnel and Administration of Medication During Before- and After-School Programs and School Readiness Programs, Connecticut General Statutes Section 10-212a-4 requires that “in the case of inhalers for asthma…students may self-administer medication with only the written authorization of an authorized prescriber and written authorization from a student’s parent or guardian or eligible student.”

Self-Administration of General MedicationSelf-Administration of General Medication: The Regulations for the Administration of Medications by School Personnel and Administration of Medication During Before- and After-School Programs and School Readiness Programs, Statute Section 10-212a-4 allows that with local board of education approval, students who have a verified chronic medical condition and are deemed capable to self-administer prescribed medications may do so with a written order from an authorized prescriber, written authorization from a parent or guardian or eligible student and approval from the school nurse.

Psychotropic Medications: Statute Chapter 169 Sec 10-212b (2003) requires each local and regional board of education to adopt and implement policies prohibiting any school personnel from recommending the use of psychotropic drugs for any child. These policies shall set forth procedures for communication between school health or mental health personnel and other school personnel about a child who may require a recommendation for a medical evaluation, establishing the method in which school health or mental health personnel communicate a recommendation to a parent or guardian that such child be evaluated by an appropriate medical practitioner, and for obtaining proper consent from a parent or guardian of a child for the school health or mental health personnel to communicate about such child with a medical practitioner outside the school who is not a school employee. These policies cannot prohibit school health or mental health personnel from recommending that a child be evaluated by an appropriate medical practitioner, school personnel from consulting with such practitioner with the consent of the parents or guardian of such child, the planning and placement team from recommending a medical evaluation as part of an initial evaluation or reevaluation, as needed to determine a child's eligibility for special education and related services or educational needs for an individualized education program.

Storage and Record-keepingThe Regulations for the Administration of Medications by School Personnel and Administration of Medication During Before- and After-School Programs and School Readiness Programs and Statute Section 10-212a-5 (2010) requires all medication, except those approved for self-medication, to be stored in a designated locked container, cabinet or closet with limited access by persons authorized to administer medications. Further, all medication shall be delivered and stored in its original container and removed from storage areas when unused, discontinued or obsolete. In the case of controlled substances, they are to be stored separately from other drugs and substances in a separate, secure, substantially constructed, locked metal or wood cabinet pursuant to Regulation 21a-262-8.

According to the Regulations for the Administration of Medications by School Personnel and Administration of Medication During Before- and After-School Programs and School Readiness Programs, Statute Section 10-212a-6 (2010), requires that each school or before- and after-school program and school readiness program where medications are administered shall maintain an individual medication administration record for each student who receives medication during school or program hours. The record must include the name of the student, medication, dosage, route and frequency of administration, the dates for initiating and terminating administration, quantity received, any student allergies to food or medicine, the date and time of administration or omission including the reason for the omission, the dose or amount of drug administered, the full written or electronic signature of the nurse or qualified personnel for schools administering the medication; and for controlled substances, a medication count which should be conducted and documented at least once a week and co-signed by the assigned nurse and a witness.


District of Columbia

Last Updated: 10/15/2013

 Staff Administration: Code 38-651.05 (2008) allows an employee or agent trained and certified according to Code 38-651.04 (2008) to administer medication to a student with a valid medication action plan, provided that the responsible person has delivered the medication to the school, the employee or agent is under the general supervision of a licensed health practitioner, and, except in emergency circumstances, the responsible person has administered the initial dose of a new medication. Responsible person is defined as a parent, legal guardian, legal custodian, foster parent, or other adult charged with the supervision of the student, and in the case of a student 18 years  or older, the student him or herself.

Code 38-651.06 (2008)states that no employee or agent of a school shall administer medication in emergency circumstances to any student unless they have been trained  and certified under the medication administration training program described in Code 38-651.04 (2008). Code 38-651.04 (2008) outlines the certification requirements. Code 38-651.06 (2008) states that a student does not need to have a known diagnosis or a medication action plan to receive treatment in emergency circumstances from a trained employee or agent of the school. The Code also provides for a procedure in which a responsibly person may request that a minor not receive treatment in an emergency.

Code 38-651.06 (2008) requires the Mayor to obtain a standing order by at least one physician licensed in DC that identifies the specific medications that may be administered in emergency circumstances and provides appropriate administration instructions.

Self-Administration of Asthma Medication:  Code 38-651.02 (2008) allows students to carry and self-administer medication at the school where they are enrolled, at school-sponsored activities and while on school-sponsored transportation, in order to treat asthma, anaphylaxis or other illness.  In order to do so, the responsible person must submit a valid medication action plan to the school, as described in Code 38-651.03.

Self-Administration of Anaphylaxis Medication: Code 38-651.02 (2008) allows students to carry and self-administer medication at the school where they are enrolled, at school-sponsored activities and while on school-sponsored transportation, in order to treat asthma, anaphylaxis or other illness.  In order to do so, the responsible person must submit a valid medication action plan to the school, as described in Code 38-651.03 (2008).

Psychotropic Medications: No policy.

Storage and Record Keeping: Code 38-651.08 (2008) outlines the requirements of maintaining records of administration of medication, medication action plans, and of employees and agents who are certified to administer medication. Code 38-651.09 (2008) allows a school to procure medication for the treatment of asthma, anaphylaxis or other illness for use in emergency circumstances. Requirements about storage are outlined in the policy.


Delaware

Last Updated: 6/11/2009

Staff Administration: Administrative Code 14:817 (2003) allows the administration of prescription and non-prescription medication by a school nurse if a written request is received from a parent or guardian, a properly labeled medication is brought in its original container to school, any allergies are noted, and annual reauthorization of long-term medication is conducted.

Self-Administration of Asthma Medication: Administrative Code 14:612 (2003), Section 3.11 states that each school district that has a policy must permit the use and possession of an asthmatic quick relief inhaler with an individual prescription label by a student with the following provisions: the student uses the inhaler as directed by a state licensed health practitioner, written authorization for the student to possess and use the inhaler is provided, and a statement releasing the school district and its employees from any liability resulting from the student's use and possession of the inhaler is given.

Self-Administration of Anaphylaxis Medication: Administrative Code 14:612 (2003), Section 3.11 states that each school district that has a policy must permit the use and possession of an auto-injectable epinephrine with an individual prescription label by a student with the following provisions: the student uses the auto-injectable epinephrine as directed by a state licensed health practitioner, written authorization for the student to possess and use the epinephrine is provided, and a statement releasing the school district and its employees from any liability resulting from the student's use and possession of the auto-injectable epinephrine is given.

Psychotropic Medications: Delaware has no policy specific to psychotropic medications. However, Administrative Code 14:817 requires controlled substances to be kept under double lock and counted and reconciled every month.

Storage and Record-keeping: Administrative Code 14:817 requires school districts to maintain a record of all students receiving assistance with medication, including the student's name, the name of the medication, the dose, the time of administration, the method of administration, and the name of the person assisting. This code also requires controlled substances to be kept under double lock and counted and reconciled every month. Administrative Code 14:811 (2003) requires school nurses to document any services provided to students.


Florida

Last Updated: 4/24/2013

Staff Administration: Statute 1006.062 (2012) requires local districts to adopt policies governing the administration of medication, which includes requiring a written statement by a parent or guardian granting permission for a designated school employee to administer medication.

Self-Administration of Asthma Medication: Statute 1002.20 (2012) allows students with asthma to carry a metered dose inhaler in school when written approval from a parent and physician is given.

Self-Administration of Anaphylaxis Medication1002.20 (2012)  allows a student who has or is at risk of experiencing a life-threatening allergic reaction to carry and self-administer an epinephrine auto-injector while in school, participating in school-sponsored activities, or in transit to and from school provided parental and physician authorization have been provided. The policy further exempts a school district, county health department or any other employee from any liability with respect to the student's use of an epinephrine auto-injector.

Self-Administration of Diabetes Medication: Statute 385.203 (2010) authoizes students with diabetes to carry equipment and suplies to manage their diabetes while in school, at school-sponsored activities, or in transit to and from school or school-sponsored activities with written authorization from the student's parents and physician. It requires the State Board of Education, in cooperation with the Department of Health, to adopt rules to encourage every school in which a student with diabetes is enrolled to train personnel in routine and emergency diabetes care, and to protect other students from unauthorized use of diabetes medications or supplies.

Self-Administration of Pancreatic EnzymeAuthorizes a student with cystic fibrosis or who has experience pancreatic insufficiency or is at risk for pancreatic insufficiency to carry and self-administer a prescribed pancreatic enzyme with written authorization from the student's parent and prescribing practitioner.

Psychotropic Medications: Statute 1006.0625 (2005) forbids a public school to deny any student access to programs or services because the parent of the student has refused to place the student on psychotropic medication. A public school teacher and school district personnel may share school-based observations of a student's academic, functional, and behavioral performance with the student's parent and offer program options and other assistance that is available to the parent and the student based on the observations. However a public school teacher and school district personnel may not compel or attempt to compel any specific actions by the parent or require that a student take medication.

Storage and Record-keeping: Section 1006.062, Florida Statutes, requires each prescribed medication to be received, counted, and stored in its original container. When the medication is not in use, this section of statute also requires that medication shall be stored in its original container under lock and key in a location designated by the school principal.

Medical Emergencies: Section 381.0056, Florida Statutes, defines “emergency health needs” to mean onsite management and aid for illness or injury pending the student’s return to the classroom or release to a parent, guardian, designated friend, or designated health care provider. Rule 64F-6.004, Florida Administrative Code, specifies requirements regarding policies, procedures, and protocols for the management of student health emergencies.


Georgia

Last Updated: 7/19/2013

Staff Administration: Code 2-20-776 (2011) requires each local board of education to adopt a policy authorizing school personnel to administer auto-injectable epinephrine, if available, to a student upon the occurrence of an actual or perceived anaphylactic adverse reaction by the student, whether or not such student has a prescription for epinephrine. Local boards of education must provide training on how to recognize the symptoms of anaphylactic shock and the correct method for administering the epinephrine. It also provides for immunity from liability for staff administering in cases of good faith.

Code 26-4-116.1 (2013) allows any school employee who has completed training or received information in recognizing the symptoms of anaphylactic shock and administration of epinephrine to provide epinephrine to any student they believe in good faith is experiencing an anaphylactic adverse reaction for immediate self-administration, or may administer epinephrine to such student, with a standing protocol from a licensed practitioner, regardless of whether or not the student has a prescription for epinephrine.

State Board of Education Rule 160-4-8-.01 (2000) requires each school system to develop a Student Services Plan that provides guidelines for its various components including school health services. The state's School Health Nurse Resource Manual (2013) provides suggested models for each school system to implement the rule. Each model includes administration of medication as a school nurse function.

Self-Administration of Asthma Medication: Georgia Code 20-2-774 (2002) requires each local board of education to adopt a policy authorizing the self-administration of asthma medication by a student, provided that the student is authorized for self-administration and may possess and use the medication while in school, at a school sponsored activity, while under the supervision of school personnel, or while in before-school or after-school care on school operated property. The code further explains that the school district and its employees are not liable for any injury to a student caused by his or her self-administration of the asthma medication. The Guidelines for Medication Administration encourages schools to allow students to personally control medications as necessary.

Self-Administration of Anaphylaxis Medication: Georgia Code 20-2-776 (2009) requires each local board of education to adopt  a policy authorizing a student to carry and self-administer prescription auto-injectable epinephrine.  A student authorized for self-administration pursuant to the Code may possess and use an auto-injectable epinephrine while in school, at a school sponsored activity, while under the supervision of school personnel, or while in before- or after-school care in a school operated property. The student's parent or guardian and a licensed physician must provide written statements whose requirements are outlined in the Code. 
 
Self-Administration of General Medication: No state policy.

Storage and Record-keeping:  Code 20-2-776.2 (2013) allows a public or private school to enter into arrangements with manufactures of approved auto-injectable epinephrine or third-party suppliers to obtain the products free of charge or at fair market or reduced prices (for puposes of storage for use in emergency). Code 26-4-116.1 (2013) allows a licensed physician, advanced practice RN and a physician assistant to prescribe auto-injectable epinephrine in the name of a public or private school for use in accordance with 20-2-776.2, and a pharmacist may dispense such a prescription.

The School Health Nurse Resource Manual (2013)and chapter 3 of the Georgia School Health Resource Manual (2004) [no link available] suggest that medication be stored in a secure, locked, clean area in a central place accessible only to designated school health personnel. A record should be on the student's record sheet each time a medication is administered.

Medical Emergencies: The School Health Nurse Resource Manual (2013) and chapter 2 of the Georgia School Health Resource Manual (2004) [no link available] recommend procedures to be followed in case of a medical emergency, including calling 911, pulling the student's Enrollment Data Sheet, and contacting the parents.


Hawaii

Last Updated: 6/11/2009

Staff Administration: Pre-service Requirement: HRS 320A-253 (2007) allows health aides to assist students in administering oral and topical medication, and in emergency situations, other premeasured medication. The following provisions must be met: (1) Parental authorization, (2) Medication has been prescribed by a licensed physician or other authorized practitioner, (3) Approval of the department of health, and (4) The administration of medication is necessary for the student's health and his or her attendance at school.

Self-Administration of Asthma Medication: HRS 302A-1164 (2004) requires the department of education to permit the self-administration of medication by a student for asthma or other potentially life-threatening illnesses. The law also allows students to carry an inhaler and requires the student's parent or guardian to sign a statement acknowledging that the district and its employees are not liable for any injury arising from the self-administration of medication. HB 1550 (2005) permits students to self-administer medication for asthma provided written authorization has been given by the student's physician and a signed statement by the parents/guardians that the department and its employees are not to incur any liability for any injury resulting from the self-administration of medication. The student is also permitted to carry an inhaler if does not endanger him/herself or others from the misuse of the inhaler.

Self-Administration of Anaphylaxis Medication:  HRS 302A-1164 (2004) requires the department of education to permit the self-administration of medication by a student for a potentially life-threatening illnesses. The law also allows students to carry an auto-injector epinephrine and requires the student's parent or guardian to sign a statement acknowledging that the district and its employees are not liable for any injury arising from the self-administration of medication. HB 1550 (2005) permits students to self-administer medication for anaphylaxis or other potentially life-threatening illnesses provided written authorization has been given by the student's physician and a signed statement by the parents/guardians that the department and its employees are not to incur any liability for any injury resulting from the self-administration of medication. The student is also permitted to carry an auto-injectable epinephrine if does not endanger him/herself or others from misuse.

Psychotropic Medications: No state policy.

Storage and Record-keeping: Health Administrative Rule 11-146-3 (1983) (no link available) requires the school health aide to maintain a confidential school record of each student.


Iowa

Last Updated: 10/13/2013

Staff Administration: 281 IAC 41.404(1-3) requires local boards to establish policies and procedures that address the administration of prescription and non-prescription medication, an individual health plan, the persons permitted to administer medication including individuals who demonstrate competency may self-administer their own medication, a course on the administration of medication, properly labeled medication containers, record-keeping of medication administration, storage of medication, a written statement by a parent or guardian requesting individual co-administration of medication, emergency protocols, and confidentiality of information. Medication Management in Iowa Schools provides additional guidance.

Self-Administration of Asthma Medication: Code 280.16 (2005) authorizes schools to permit the self-administration of medication by a student with asthma or other airway constricting diseases provided that parental or guardian authorization and a statement by the student's physician containing information about the name and purpose of the medication, the prescribed dosage, and the times or special circumstances under which the medication shall be administered are given. In addition, the code protects the school district and its employees from incurring any liability for any improper use of medication by a student when self-medicating.

Self-Administration of  Anaphylaxis Medication: Code 280.16 (2005) authorizes schools to permit the self-administration of medication by a student with asthma or other airway constricting diseases provided that parental or guardian authorization and a statement by the student's physician containing information about the name and purpose of the medication, the prescribed dosage, and the times or special circumstances under which the medication shall be administered are given. In addition, the code protects the school district and its employees from incurring any liability for any improper use of medication by a student when self-medicating.

Psychotropic Medications: Use school medication administration policy and procedures. No specific state policy. 

Storage and Record-keeping281 IAC 41.404(1-3) requires each local school board or authority in charge of an accredited nonpublic school to adopt policies for medication to be stored in a secure area and to maintain written records of administration.

Medical Emergencies281 IAC 41.404(3) requires each local school board or authority in charge of an accredited nonpublic school to adopt policies requiring emergency protocols for medication-related reactions.


Idaho

Last Updated: 2/28/2013

Staff Administration: No state policy.

Self-Administration of Asthma Medication
: Statute 33-520 (2008) requires each school district to adopt a policy permitting the self-administration of medication by way of metered-dose inhaler by a pupil for asthma or other potentially life-threatening respiratory illness or an epinephrine auto-injector for severe allergic reaction. The student shall be permitted to possess and use the prescribed the inhaler at all times. Schools may require pupils to maintain duplicate prescription medications with the school nurse or in the absence of a school nurse, school administrator..

Self-Administration of Anaphylaxis Medication
:
  Statute 33-520 (2008) requires each school district to adopt a policy permitting the self-administration of medication by way of metered-dose inhaler by a pupil for asthma or other potentially life-threatening respiratory illness or an epinephrine auto-injector for severe allergic reaction. The student shall be permitted to possess and use the prescribed the epinephrine auto-injector at all times. Schools may require pupils to maintain duplicate prescription medications with the school nurse or in the absence of a school nurse, school administrator.

Psychotropic Medications: No state policy.

Storage and Record-keeping: No state policy.


Illinois

Last Updated: 12/26/2012

Staff-Administration: State Board of Education 23 Administrative Code Ch. 1-b, Section 23.120 (2002) outlines the standards of a school nurse to include the administering and monitoring medication and treatment given in school. This code is, however, subject to local policy regarding the administration of medication at school.

105 ILCS 5/22-30 (2011) allows a school district or nonpublic school to authorize a school nurse to administer an epinephrine auto-injector to a student or any personnel authorized under a student’s Individual Health Care Action Plan or Illinois Food Allergy Emergency Action Plan and Treatment Authorization Form. It also allows authorization of a school nurse to administer an epinephrine auto-injector to any student that the school nurse in good faith professionally believes is having an anaphylactic reaction. The statute provides for immunity from liability, except in cases of wanton and willful conduct. Schools are allowed to maintain a supply of epinephrine auto-injectors in a locked, secure location. The school supply of epinephrine may be used by any student authorized to self-administer, as outlined in the statute. When a student does not have an epinephrine auto-injector or a prescription on file, the school nurse may use the school supply to respond to an anaphylactic reaction, under a standing protocol from a physician. (1998) requires local school boards to develop a medications policy for the administration of medication in schools and provide a copy of the policy to parents or guardians of each student.

105 ILCS 5/10-22.21b (2000) limits the administration of medication during school hours and during school-related activities to situations in which it is necessary for the critical health and well-being of the student. The code only permits certified school nurses and non-certificated registered professional nurses to administer medication. Each school district must devise a program for the administration of medications that includes designation of the staff member to administer the medication, documentation of each dose of medication, long-term effects, and any medication errors. Medications should also be stored in a separate locked drawer or cabinet, fixed to the wall if it is a controlled substance, and in the refrigerator separate from food products when needed. The specifics of suggested procedures are outlined in the Recommended Guidelines for Medication Administration in Schools (2000).

Public Act 096-1485 (2010) requires, in schools that have a student with diabetes, all school employees to receive training in the basics of diabetes care. Delegated aides shall be trained to perform the tasks necessary to assist a student with diabetes. Requirements of the training are outlined in the statute. The act also requires a parent or guardian to submit a diabetes care plan for a student with diabetes who seeks assistance with diabetes care at school. The plan authorizes delegated care aides to assist a student with diabetes in accordance with the care plan. It also

Self-Administration of Asthma Medication: 105 ILCS 5/22-30 (2006) requires a school to permit the self-administration of medication by a student with asthma, provided that the parents or guardians provide written authorization for self-administration and a written statement from the student's licensed health care provider with the name and purpose of the medication, the prescribed dosage, and the time or circumstances the medication is to be administered is provided. The act further instructs school districts to inform parents in writing that its employees are not liable for any injury arising from the self-administration of medication by the student. The parents are then required to sign a statement acknowledging that school district and its employees are exempt from liability. According to this statute, students may possess and use the medication while in school, while at a school-sponsored activity, while under the supervision of school personnel, or before or after normal school activities.

Self-Administration of Anaphylaxis Medication: 105 ILCS 5/22-30 (2006) requires a school to permit a student to self-administer an epinephrine auto-injector, provided that the parents or guardians provide written authorization for self-administration and a written statement from the student's licensed health care provider with the name and purpose of the medication, prescribed dosage, and the time or circumstances the medication is to be administered is provided. The act further instructs school districts to inform parents in writing that its employees are not liable for any injury arising from the self-administration of medication by the student. The parents are then required to sign a statement acknowledging that school district and its employees are exempt from liability. According to this statute, students may possess and use the medication while in school, while at a school-sponsored activity, while under the supervision of school personnel, or before or after normal school activities.

Psychotropic Medications: 105 ILCS 5/10-20.36  (2002) requires each school board to adopt and implement a policy prohibiting any disciplinary action that is based totally or in part on the refusal of a student's parent or guardian to administer or consent to the administration of psychotropic or psychostimulant medication to the student. 

Storage and Record-Keeping: No state policy.

 


Indiana

Last Updated: 12/6/2010

Staff Administration: Code 20-34-3-6 (2005) allows the governing body of each school corporation to appoint one or more nurses who are registered to practice nursing in Indiana who is responsible for emergency nursing care of children when an illness or accident occurs during school hours or on or near school property. Code 34-30-14-1 (1998) disallows school boards from requiring school personnel to administer medication to pupils unless they are employed as a school nurse or physician. Code 34-30-14-2 (1998) does, however, allow a school employee designated by the school administrator after consultation with the school nurse to administer non-prescription medication with written permission of the parent or guardian. The code further protects school employees who act in good faith from liability for civil damages as a result of the administration.

511 IAC 4-1.5-6 requires school corporations to employ at least one registered nurse with a Bachelor's of Science in Nursing to coordinate health services. The code also requires schools to provide health services at the elementary and secondary levels.

Staff Administration of Diabetes Medication: Code 20-34-5 (2007) allows school nurses to administer glucagon, insulin, or other emergency treatments prescribed by a licensed health care practitioner to diabetic students with an individual health plan and diabetes management plan.  It also allows for staff members to serve as voluntary health aides after receiving diabetes training, including testing and the administration of medication. A volunteer health aide may perform the tasks necessary to assist a student in carrying out his or her individualized health plan, in compliance with the training guidelines provided in Code 20-34-5 (2007). This includes the administration of glucagon, insulin or other emergency treatments. A volunteer health aide may act to assist a student only if the parent or guardian signs an agreement that authorizes the volunteer aide to assist the student, and states an understanding that the aide is not liable for civil damages for assisting in the student's care. 

Self-Administration of Asthma Medication: Code 20-33-8-13 (2005) permits students with a chronic disease or medical condition to possess and self-administer medication for the chronic disease or medical condition upon the written request of a parent or guardian. The physician must also state in writing that the student has a chronic disease or medical condition for which the physician has prescribed the medication, the student has been instructed on how to administer the medication, and the nature of the disease or medication condition requires emergency administration of medication. Code 34-30-14-6 (2001) declares a school or school board not liable for civil damages as a result of a student's self-administration of medication.

Self-Administration of Anaphylaxis Medication:  Code 20-33-8-13 (2005) permits students with a chronic disease or medical condition to possess and self-administer medication for the chronic disease or medical condition upon the written request of a parent or guardian. The physician must also state in writing that the student has a chronic disease or medical condition for which the physician has prescribed the medication, the student has been instructed on how to administer the medication, and the nature of the disease or medication condition requires emergency administration of medication. Code 34-30-14-6 (2001) declares a school or school board not liable for civil damages as a result of a student's self-administration of medication.

Self-Administration of Diabetes Medication: Code 20-34-5 (2007) allows a student to attend to the management and care of their diabetes, permitting the student has been evaluated and determined to be capable of doing so, as reflected in their individual health plan and diabetes management and treatment plan. This includes the administration of insulin and possession of relevant supplies in any area of the school or school grounds, or at any school related activity.  

Psychotropic Medications: No state policy. 

Storage and Record-keeping: No state policy.


Kansas

Last Updated: 10/13/2013

Staff Administration: KAR 60-15-101   (2009) states that only a licensed registered professional nurse (or a physican provider) has the authority to delegate the administration of medication or other nursing procedures in schools to unlicensed assistive presonnel (UAP) and only with appropriate and adequate training, supervision and performance evaluation of the UAP. KAR 60-15-102 (2009)  requires that nursing procedures (including medication administration) in the schools can only be deelegated by a licensed registered professional nuse. This includes a nursing asessment of the student and the development of a plan of care for the student that may include delegation to a UAP. The KSBN provides additional guidance for delegation procedures in their tool Delegation of Specific Nursing Tasks in the School Setting for Kansas. KAR 60-15-103 requires a registered professional nurse or licensed practical nurse to supervise all nursing tasks or procedures delegated to an unlicensed person in the school setting. KAR 60-15-104 states that If the requirements of KAR 60-15-101 through 60-15-103 have been met, the unlicensed registered professional nurse may delegate medication administration to a UAP if: (1) No dosage calculation is required and, (2) The medication is administered by accepted methods specified in the nursing plan of care. A registered professional nurse may not delegate the procedure of medication administration in a school setting to unlicensed persons when administered by any of these means: (1) By intravenous (IV) route, (2) By intramuscular (IM) route, except when administered in an anticipated health crisis, (3) Through intermittent positive-pressure breathing machines; or (4) Through an established feeding tube that is not inserted directly into the abdomen. Guidelines for Medication Administration in Kansas Schools (2010) provides guidance on implementation of all of these statutes.

KSA 72-8258 (2009) allows any person to administer epinephrine to a student or staff member in an emergency situation if the person is exhibiting the signs and symptoms of of an anaphylactic reaction and  if a physician has instructed the school in writing to maintain a stock supply of epinephrine. The epinephrine may be administed at school, on school property , or at a school-sponsored event. In addition, the statute provides immunity from liability for civil damages for any person who "gratuitously and in good faith renders emergency care or treatment through the administration of epinephrine to a student or a member of a school staff at school."

KSA 72-8258 (2009) state that epinephrine from an epinephrine kit shall be used only in emergency situations when the person administering the epinephrine reasonably believes that the signs and symptoms of an anaphylactic reaction are occurring and if administered at school, on school property or at a school-sponsored event. 


Self-Administration of Asthma Medication: Statute 72-8252 (2012) requires each school district to adopt a policy authorizing the self-administration of medicine by students in grades K-12. "Medicine" is defined as medicine prescribed by a health care provider for the treatment of anaphylaxis or asthma including, but not limited to, any medicine defined in section 201 of the federal food, drug and cosmetic act, inhaled bronchodilators and auto-injectible epinephrine."

To self-administer medication, a student must satisfy the requirements of providing a written statement from the student's health care provider with a description of the name and purpose of the medication, the prescribed dosage, the time and any additional circumstances the medication is to be administered, and the length of time for the prescription; and providing written authorization from the student's health care provider and parent/guardian ensuring that the student has been instructed on self-administration of the medication and is authorized to do so in school. The Statute protects the school district and its employees from any liability from injury resulting from the self-administration of medication.

Self-Administration of Anaphylaxis Medication: Statute 72-8252 (2012) requires each school district to adopt a policy authorizing the self-administration of medicine by students in grades K-12. "Medicine" is defined as medicine prescribed by a health care provider for the treatment of anaphylaxis or asthma including, but not limited to, any medicine defined in section 201 of the federal food, drug and cosmetic act, inhaled bronchodilators and auto-injectible epinephrine."

To self-administer medication, a student must satisfy the requirements of providing a written statement from the student's health care provider with a description of the name and purpose of the medication, the prescribed dosage, the time and any additional circumstances the medication is to be administered, and the length of time for the prescription; and providing written authorization from the student's health care provider and parent/guardian ensuring that the student has been instructed on self-administration of the medication and is authorized to do so in school. The school district must also require that any back-up medication provided by the student's parent or guardian be kept at the student's school in a location to which the student has immediate access in the event of an asthma or anaphylaxis emergency. The school district must also require that any back-up medication provided by the student's parent or guardian be kept at the student's school in a location to which the student has immediate access in the event of an asthma or anaphylaxis emergency. The Statute protects the school district and its employees from any liability from injury resulting from the self-administration of medication.

Psychotropic Medications: No specific state policy.

Storage and Record-keeping: KSA 72-8258 (2012) allows any accredited school to maintain an epinephrine kit. The school must consult with a licensed pharmacist who shall be responsible for developing procedures, proper control and accountability for the epinephrine kit. Periodic physical inventory of the epinephrine kit shall be required.


Kentucky

Last Updated: 10/14/2013

Staff Administration: KRS 156.502 (2002) allows for the delegation of school health services by a physician or advanced practice registered nurse or registered nurse (service must be one that could be delegated by the physician or nurse within his/her scope of practice).  The school employee who is delegated by the physician or nurse to perform the health service must be trained and receive written approval by the delegating health professional.  Such employees who have been properly delegated and trained will be granted liability protection. Delegation is only valid for the current school year. Statute 156.501 (2002) requires the Department of Education to establish standardized protocols and guidelines for training said designated, non-licensed school personnel. 702 KAR 1:160 Section 4 (g) requires unlicensed school personnel who have accepted the delegation to administer medications to show proof of successful completion of the Kentucky Department of Education-provided Medication Administration Training course. This training is valid only for the current school year.

Health services are defined in the statute as providing direct health care, including the administration of medication. The statute further protects a school employee who has been properly trained and been delegated responsibility for performing a medical procedure to be granted liability protection unless clear and convincing evidence of negligence or misconduct has resulted in individual harm.
Beginning with the 2010-2011 school year, a local board of education must maintain proof that non-licensed school employees who have accepted the delegation to administer medications in schools have completedthe Kentucky Department of Education-provided Medication Administration Training Program.

Self-Administration of Asthma Medication: KRS 158.834 (2002) authorizes the board of a school district to permit students with asthma to self-administer medication provided that written authorization is received from the student's parent or guardian and the student’s parent or guardianprovides a written statement from the student’s health practitioner, that includes the student’s name, name and purpose of the medication, the prescribed dosage, time the medication is to be administered or under what additional special circumstances the medications are to be administered, and the length of time for which the medications are prescribed. Parents and guardians are to be notified, and the parent or guardian shall sign a statement acknowledging, that the school will incur no liability forany claims regarding the self-administration of asthma medications by the student. KRS 158.836 (2004) allows students with asthma to possess and use their medication at school and at school-sponsored activities located on school property, provided that written authorization from a parent or guardian and a healthcare practitioner is provided in accord with KRS 158.834.

Self-Administration of Anaphylaxis Medication:  KRS 158.834 (2002) authorizes the board of a school district to permit students at risk of anaphylaxis to self-administer medication provided that written authorization is received from the student's parent or guardian and provides a written statement from the student’s health practitioner, that includes the student’s name, name and purpose of the medication, the prescribed dosage, time the medication is to be administered or under what additional special circumstances the medications are to be administered, and the length of time for which the medications are prescribed. Parents and guardians are to be given notification and the parent or guardian shall sign a statement acknowledging that the school will incur no liability for any claims regarding the self-administration of asthma medications by the student. KRS 158.836 (2004) allows students at risk for anaphylaxis to possess and use their medication at school and at school-sponsored activities located on school property, provided that written authorization from a parent or guardian and a healthcare practitioner is provided in accord with KRS 158.834.  

Emergency administration of diabetes medication: 
KRS 158.838 (2005) requires the board of a school district to have at least one (1) school employee at each school who has met the requirements of KRS 156.502 on duty during the entire school day to administer in an emergency Glucagon subcutaneously, using a glucagon emergency kit, to students with diabetes who are experiencing signs of hypoglycemia or other conditions noted in the health care provider’s written statement.  The student’s parent or guardian shall provide written authorization to administer Glucagon at school and a written health care provider’s statement that includes the student’s name, name and purpose of the medication, the prescribed dosage, route of administration, frequency and that the medication may be administered. The student’s parent or guardian shall provide the medication to the school in its unopened, sealed package with the label affixed by the dispensing pharmacy intact. Parents and guardians are to be given notification and the parent or guardian shall sign a statement acknowledging that the school will incur no liability against any claims regarding as a result of any injury sustained by the student from any reaction to the administration of any medication to treat a hypoglycemic episode unless clear and convincing evidence of negligence or misconduct has resulted in individual harm.

Emergency administration of seizure disorder medications: 
KRS 158.838 (2005) requires the board of a school district to have at least one (1) school employee at each school who has met the requirements of KRS 156.502 on duty during the entire school day to administer in an emergency Diazepam rectal gel in a prefilled unit-dose delivery system. The student’s parent or guardian shall provide written authorization to administer Diazepam rectal gel at school and a written health care provider’s statement that includes the student’s name, name and purpose of the medication, the prescribed dosage, route of administration, frequency and that the medication may be administered. The student’s parent or guardian shall provide the medication to the school in its unopened, sealed package with the label affixed by the dispensing pharmacy intact. Parents and guardians are to be given notification and the parent or guardian shall sign a statement acknowledging that the school will incur no liability against any claims regarding as a result of any injury sustained by the student from any reaction to the administration of any medication to treat a seizure unless clear and convincing evidence of negligence or misconduct has resulted in individual harm.

Medical Emergencies
: 702 KAR 1:160 (2012) requires schools to have emergency care procedures in place, which include maintaining first aid facilities, having at least one adult present with children during school hours with standard first aid and CPR for infants and children training, keeping vital contact information such as the parent's telephone number and the name of the family physician.

Storage and Record-keeping
: KRS 156.501 (2002) requires the Department of Education to establish standardized protocols and guidelines for the appropriate documentation and recordkeeping of health services by a school employee. 702 KAR 1:160 Section 3 (2012) requires the school to keep a cumulative health record for each pupil to be maintained throughout the pupil’s attendance. The record shall be on the form KDESH006 or may be maintained electronically in the student information system.

Louisiana

Last Updated: 9/5/2013

Staff Administration: RS 17:28 (1995) requires each school system to employ at least one school nurse certified by the State Board of Elementary and Secondary Education, but shall not exceed a statewide average of one certified school nurse for each one thousand five hundred students, who shall be responsible for performing health care services in compliance with the rules and regulations as established by the Louisiana State Board of Nursing.

Parents/guardians, students, school staff, and health professionals are required to follow specific mandates in Chapter 11 of Bulletin 741 (2005), the state policy on medication, to ensure the health, safety, and welfare of the students. RS 17:436.1 (2001) requires all medication administered to students in the public school setting to have a physician, dentist, or other authorized prescriber's order and a request and authorization from the parent/guardian of the student. Specific mandates in this exception to the Louisiana Nurse Practice Act provide for a school employed physician or registered nurse under certain conditions to train and supervise unlicensed personnel in the administration of specific medications to specific students. Further details are provided in Rule The Administration of Medication in Louisiana Public Schools (1994).

RS 17:436.1 (2001) requires that the State Board of Elementary and Secondary Education and the Louisiana State Board of Nursing formulate and adopt a joint policy on the administration of medications for local school systems that requires unlicensed personnel to perform those functions and allows a registered nurse and/or licensed medical physician to determine that the administration of medication can be safely performed by and delegated to someone who has received documented training and competence. The Louisiana Administration of Medication in Louisiana Public Schools Policy (LAC 28:929) (2001) requires at least 2 employees designated by the principal at each school to receive not less than 6 hours of training including: proper procedures for administration of medications including controlled substances; storage and disposal of medications; appropriate and correct record keeping; appropriate actions when unusual circumstances or medication reactions occur; and appropriate use of resources. Only oral, inhalant, topical ointment for diaper rash, and emergency medications may be administered at school by unlicensed personnel.

Self-Administration of Asthma Medication: RS 17:436:1 (2009) allows a student who has received prior instruction in self-administration and has a written treatment plan from a physician to carry and store with the school nurse an inhaler at all times.

Self-Administration of Anaphylaxis Medication
RS 17:436:1 (2009) allows a student who has received prior instruction in self-administration and has a written treatment plan from a physician to carry and store with the school nurse auto-injectable epinephrine.

Psychotropic Medications: RS 17:436 (1991)  prohibits teachers from making recommendations for students to be administered psychotropic drugs; specifying or identifying any specific mental health diagnosis for a student; and using a parent or guardians refusal to consent to administration of a psychotropic drug or evaluation, screening or examination as grounds for prohibiting the student from attending class or participating in any school related activities. 

Storage and Record-keeping: 1129 of Bulletin 741 (2005), requires all medications to be stored in a secured locked area or drawer with limited access only by authorized personnel.


Massachusetts

Last Updated: 11/23/2011

Staff Administration : General Law 71.54B (2002) requires the state department of public health to establish regulations governing the administration of medications in school settings. 105 CMR 210.003 (1994) mandates school committees (local boards of education), in consultation with their local boards of health, adopt policies and procedures governing the administration of prescription medications. These policies should include the designation of a supervising school nurse, response to a medication emergency, dissemination of information to parents and guardians, and procedures for the resolution of questions between parents and the school. This policy also allows schools to administer epinephrine by auto-injector in life-threatening situations during the school day. 105 CMR 210.005 (1994) requires the school nurse to ensure that there is a proper medication order from a licensed prescriber, and a written authorization by a parent or guardian that approves the administration of prescription medication by the school nurse or designated school personnel.

105 CMR 210.100 allows a public school or non-public school district to register with the Department of Education to allow trained personnel to administer an epinephrine auto-injector in a life-threatening situation during the school day when a nurse is not immediately available. Conditions for the administration are outlined in the statute. Administration may occur in before or after school programs administered by the school, special school events and schools-sponsored activities on weekends if approved in the school policy developed pursuant to 105 CMR210.100.

Self-Administration of Asthma Medication: 05 CMR 210.006 (1994) allows the self administration of medication by students that is consistent with school policy provided that the student, school nurse, and parent or guardian enter into an agreement specifying under which conditions prescription medication may be self-administered. General Law 71.54B further clarifies that school districts may not prohibit students with asthma or other respiratory diseases from possessing and self-administering prescription inhalers.

Self-Administration of Anaphylactic Medication 05 CMR 210.006 (1994) allows the self administration of medication by students that is consistent with school policy provided that the student, school nurse, and parent or guardian enter into an agreement specifying under which conditions prescription medication may be self-administered. 

Self-Administration of Diabetes Medication05 CMR 210.006 (1994) allows the self administration of medication by students that is consistent with school policy provided that the student, school nurse, and parent or guardian enter into an agreement specifying under which conditions prescription medication may be self-administered. General Law 71.54B further clarifies school district shall not prohibit a student with diabetes from possessing and administering a glucose monitoring test and insulin delivery system, in accordance with department of public health regulations concerning a student’s self-administration of a prescription medication.

Self-Administration of General Medication: 105 CMR 210.006 (1994) allows the self administration of medication by students that is consistent with school policy provided that the student, school nurse, and parent or guardian enter into an agreement specifying under which conditions prescription medication may be self-administered. Further, written authorization from a student's parent or guardian that allows self-administration of prescription medication is provided.  105 CMR 210.003 requires the school committee (local boards of education) or board of trustees to adopt policies and procedures governing the administration of prescription medications and self administration of prescription medications within the school system. 

Storage & Record-keeping: 105 CMR 210.003 mandates school committees (local boards of education), in consultation with their local boards of health, adopt policies for the documentation of the administration of prescription medications, storage of prescription medications, and reporting and documenting of medication errors.

Psychotropic Medications: General Law 71.54B states that "the department of public health shall promulgate regulations governing the administration of medications, including psychotropic medications to children in school settings".


Maryland

Last Updated: 10/14/2013

Staff Administration: State Board of Education Regulation 13A.05.05.08 (1995) mandates local boards of education in conjunction with local health departments to develop policies ensuring school health services to be provided to all students with special health needs. The designated school health services professional can serve on the pupil services team and participate in the health services component of an Individualized Education Plan, the Individualized Family Service Plan, or the Transitional Plan committees.

Code 7–426.2 requiring each county board of education to establish a policy to authorize certain school personnel to administer auto–injectable epinephrine to a student perceived to be in anaphylaxis, regardless of whether the student has been identified as having an anaphylactic allergy or has a prescription for epinephrine as prescribed by an authorized licensed health care practitioner.

SB 26 (2009) provides immunity from civil liability for an act or omission in the course of responding to an anaphylactic reaction of a child (except for any willful or grossly negligent act). 

Additional Guidance is provided in Delegation of Nursing Functions in a School Setting: Maryland State School Health Services Guideline (2006). 

Self-Administration of Asthma MedicationCode 7-421 (2005) requires schools to allow students to carry an asthma inhaler if an order is received by a physician and the school nurses reviews the student's technique. State Board of Education Regulation 13A.05.05.08 requires local boards of education, with the local health department, to formulate written policies regarding the administration of medication during school hours and school-sponsored activities.

Self-Administration of Anaphylactic MedicationCode 7-421 (2005) requires schools to allow students to self-administer an emergency medication if an order is received by a physician and the school nurses assess the student's technique. State Board of Education Regulation SB 26 (2009) requires the prinicipal of a public school in which a student has been identified as having an anaphylactic allergy to establish procedures for self-administration of medication by the student if he or she is determined to be capable of such administration. A school may revoke the authority of a child to self-administer if the child endangers himself or herself or another child through misuse.


Self-Administration of General Medication: The Maryland State School Health Services - Guidelines for the Administration of Medication in Schools addresses how the needs of students requiring medication should be addressed, planned for and documented. This document addresses self-administration of medication. A statewide medication form allows for a physician to order that a student may self-administer medication with the approval of the school nurse. 

Psychotropic Medications: No specific state policy. The Maryland State School Health Services - Guidelines for the Administration of Medication in Schools addresses how the needs of students requiring medication should be addressed, planned for and documented.

Storage and Record-keeping: State Board of Education Regulation 13A.05.05.08 requires local boards of education, with the local health department, to formulate written policies regarding the storage and administration of medication during school hours and school-sponsored activities. State Board of Education Regulation 13A.05.05.10 (1991) requires school buildings to make available locked file cabinets to use for storing health records and medications. The Maryland State School Health Services - Guidelines for the Administration of Medication in Schools addresses how the needs of students requiring medication should be addressed, planned for and documented, including storage and record keeping.

Medical Emergencies: State Board of Education Regulation 13A.05.05.09 (1991) requires a guide for emergency care management be developed and distributed by local health departments and boards of education to each school. Also, emergency information cards are to be maintained for each student and updated annually. Finally, emergency evacuation plans are required to be developed in consultation with the fire department, and shall include provisions for physically handicapped and other special health needs students.

State Board of Education Regulation 13A.05.05.08 requires the designated school health services professional to make a nursing care plan in case of emergency for individual students based on their special health needs. State Board of Education Regulation 13A.08.01.08 (2003) requires local boards of education to adopt policies on alcohol and other drug use or possession, including the provision of emergency medical care.


Maine

Last Updated: 10/13/2013

Staff Administration: Statute Title 20-A 6403-A (1985) requires each school board to appoint a registered professional nurse to supervise and coordinate health services and health-related activities. Further details for the administration of medication by school personnel is found in Guidelines - Training of Non-Licensed Personnel in Medication Administration Instructor's Manual (2006).

Statute Title 20-A 254, Section 5A requires the commissioner of the department of education to adopt administration of medication rules for public schools. Statute Title 20-A 254, Section 5B (1999) further requires public schools to have written local policy and procedures for administering medication. DOE Rules on medication administration are found in Chapter 40 (2006).

Self-Administration of Asthma Medication: Statute Title 20-A 254, Section 5C (2003) requires each local school to have written policy authorizing students to possess and self-administer emergency medication from an asthma inhaler. The policy must include prior written approval from the student's primary healthcare provider and from the parents or guardians, and the school nurse must evaluate the student's technique of use of medication. DOE Rule Chapter 40 requires public schools to have written local policy authorizing students to possess and self-administer emergency medication from an asthma inhaler or an epinephrine pen. A student must have prior written approval from a primary health care provider and the parent or guardian if the student is a minor, and the school nurse must evaluate the student's technique in their use of medication.

Self-Administration of Anaphylaxis Medication: Statute Title 20-A 254, Section 5C (2003) requires each local school to have written policy authorizing students to possess and self-administer emergency medication from an epinephrine pen. The policy must include prior written approval from the student's primary healthcare provider and from the parents or guardians, and the school nurse must evaluate the student's technique of use of medication. DOE Rule Chapter 40 requires public schools to have written local policy authorizing students to possess and self-administer emergency medication from an asthma inhaler or an epinephrine pen. A student must have prior written approval from a primary health care provider and the parent or guardian if the student is a minor, and the school nurse must evaluate the student's technique in their use of medication.

Psychotropic Medications
: No state policy.

Storage and Record-keeping: Secretary of State Rule Chapter 29 (2005) requires records to be stored in a fire proof safe or vault. It requires that health records be kept for 6 years after the student reaches 18 years of age or return to the parent or student.


Michigan

Last Updated: 12/20/2012

Staff Administration: State Board of Education Administrative Code 340.1163 (1979) defines the functions of a school nurse as one who assesses the health status of students and provides medical assistance to enable optimum health for students in the education process.

MCL 380.1178a (2002) requires the department to make available to all school districts, intermediate school districts, and public school academies a model local policy concerning the administration of medications to pupils at school. The policy shall address the type and amount of training that may be required for persons administering medications to pupils in schools. School boards, intermediate school boards, and public school academy boards of directors are encouraged to align their local policies with the model policy.

MCL 380.1178 (2000) protects school employees administering medication in the presence of another adult or in a life-threatening emergency in accordance with written parental permission and physician's instructions are not liable in a criminal action or for civil damages as a result of the administration. The Code further exempts licensed registered school nurses from liability regardless of whether medication was administered in the presence of another adult.

In 2003, The State Board of Education adopted the Policy on Coordinated School Health Programs to Support Academic Achievement and Healthy Schools that also recommends that each school district develop, adopt, and implement a school health services program that includes medication administration, case management for students with chronic health conditions, and a host of preventative services as part of a Comprehensive School Health Program.

Self-Administration of Asthma Medication: MCL 380.1179 (2004) allows a pupil to use and possess a metered dose inhaler or a dry powder inhaler to alleviate asthmatic symptoms at school, on school-sponsored transportation, or at any activity, event, or program sponsored by the pupil's school. The code requires written approval from the pupil's physician and the parent or legal guardian if the child is a minor. The school district shall not be liable for damages arising from a pupil being permitted or not permitted to use an inhaler. Lastly, the code allows school districts to request an extra inhaler from the pupil's parent or guardian to use at school in cases of emergency.

In 2005, the State Board of Education adopted the Policy on the Management of Asthma in Schools that recommends schools provide appropriate school health services for students with asthma by developing and implementing policies that ensure students have immediate access to asthma medications by allowing students to self-carry and self-administer asthma medications, inhalers, and Epi-Pens.

Self-Management of Anaphylaxis MedicationMCL 380.1179 (2004) allows a pupil to use and possess an epinephrine auto-injector or epinephrine inhaler on school-sponsored transportation, or at any activity, event, or program sponsored by the pupil's school. The code requires written approval from the pupil's physician and the parent or legal guardian if the child is a minor. The school district shall not be liable for damages arising from a pupil being permitted or not permitted to use an auto-injector. Lastly, the code allows school districts to request an extra auto-injector from the pupil's parent or guardian to use at school in cases of emergency.

Psychotropic Medications: No state policy.

Storage and Record-keepingModel Policy and Guidelines for Administering Medications to Pupils at School (2002) addresses “Policies for Storage and Access to Medications in School” and “Policies for Record-Keeping Related to Medications in Schools." The development and review of the model policy was required by law (Section 1178a of the School Code). MCL 380.1179 allows a school district to request an extra inhaler or Epi-Pen from a student's parent or guardian to be given to designated personnel for emergency use, however, parents or guardians are not required to provide one.

Medical Emergencies: In 2003, The State Board of Education adopted the Policy on Coordinated School Health Programs to Support Academic Achievement and Healthy Schools that recommends each school district develop, adopt, and implement a school health services program that includes emergency/urgent care.


Minnesota

Last Updated: 7/20/2009

Staff Administration: Statute 121A.22 (2004) requires that local school districts, in consultation with a licensed school nurse or public health nurse, develop a policy on medication administration. Further, the Statute requires that the administration of medications may only occur when the parent or pupil requests school personnel to administer the medication or when it is allowed by the individual education plan of a child with a disability. The statute requires each medication to be stored in a pharmacy labeled container and administered by a school nurse according to the instructions on the label. Guidelines for Administration of Medication (2005) address issues for further consideration by school districts.

Self-Administration of Asthma Medication: Statute 121A.22 allows prescription asthma inhalers and nonsyringe injectors of epinephrine to be self-administered by pupils with written authorization from the parent or guardian. Statute 121A.221 (2001) requires the school nurse to assess the student's knowledge and ability to possess and use an asthma inhaler in school, or a parent may submit such an assessment from the prescribing health care provider.

Self-Administration of Anaphylaxis MedicationsStatute 121A.2205 requires public schools to work with a student's parent and school staff to develop and implement a written individualized health plan students who are prescribed a nonsyringe epinephrine injector. The plan must enable a student to possess an auto-injector or, if a parent or prescribing physician determines that a student is unable to possess the epinephrine, designate the school staff responsible for implementing the students health plan. The Statute provides immunity from liability for any act or failure to act, made in good faith, in relation to administration of epinephrine.

Self-Administration of General Medication: Statute 121A.222 (2005) allows secondary students to possess and use nonprescription pain relievers with annual written authorization from the student's parent. This does not apply to any drug or product containing ephedrine or pseudoephedrine. The permission may be revoked if misued.

Psychotropic Medications: Statute 125A.091 (2004) states, "A parent, after consulting with health care, education, or other professional providers, may agree or disagree to provide the parent's child with sympathomimetic medications "  This statute is within the provisions regarding special education dispute resolution and due process.  The same concept is repeated regarding student suspensions:  Statute 121A.41 (2005) - "the readmission plan must not obligate a parent to provide a sympathomimetic medication for the parent's child as a condition of readmission." The same parent rights pertain when dealing with truancy (Statute 260A.01 (2004)) and child protection (Statute 260C.163 (2005).

Storage and Record-keeping: The Guidelines for Administration of Medication (2005) address issues for consideration by school districts, including storage and record-keeping.


Missouri

Last Updated: 8/28/2013

Staff Administration: Revised Statute 167.621.1 (2002) requires parental authorization before providing health services including the administration of drugs or treatment. The statute does not require school employees to administer medication or medical services for which the employee is not qualified according to standard medical practices. The statute further protects school employees from any liability if procedures adopted by the local school board were followed. The Medication Guidelines provides further guidance regarding the administration of medications in schools. 

Revised Statute 
167.630 (2006) allows each school board to authorize a licensed school nurse to maintain a stock of pre-filled epinephrine auto syringes.  It also authorizes a school nurse to administer an epinephrine auto syringe on any student believed to be having a life-threatening anaphylactic reaction.

The 
Missouri School Improvement Program  (MSIP) (2004) requires districts to have developed and implemented a school health services program which must include board-approved policies on the administration of medication.

Self-Administration of Asthma Medication: Revised Statute 
167.627.1 (2010) allows any board of education district to permit the self-administration of any medication prescribed or ordered by a physician for the treatment of asthma.  In order to obtain authorization, the student must present the following: (1) written authorization by the parents or guardians, (2) the student has demonstrated the skill level necessary to use the medication, (3) the student's physician has approved and signed a written treatment plan for managing asthma, and (4) the parent or guardian has signed a statement exempting the school district and its employees from liability as a result of any injury arising from the self-administration of medication.  Once authorization is granted, it permits a student to possess and self-administer asthma medication for one school year.  Students may self-administer medication while in school, at a school-sponsored activity, and in transit to or from school or a school-sponsored activity. The Missouri School Asthma Manual (2011) provides guidance and tools to help schools implement the statute and manage student asthma at school.

Self-Administration of Anaphylaxis Medication: Revised Statute 
167.627.1 (2010) allows any board of education district to permit the self-administration of any medication prescribed or ordered by a physician for the treatment of anaphylaxis.  In order to obtain authorization, the student must present the following: (1) written authorization by the parents or guardians, (2) the student has demonstrated the skill level necessary to use the medication, (3) the student's physician has approved and signed a written treatment plan for managing asthma, and (4) the parent or guardian has signed a statement exempting the school district and its employees from liability as a result of any injury arising from the self-administration of medication.  Once authorization is granted, it permits a student to possess and self-administer anaphylaxis medication for one school year.  Students may self-administer medication while in school, at a school-sponsored activity, and in transit to or from school or a school-sponsored activity.

Psychotropic Medications: No state policy.

Storage and Record-keeping: No state policy.


Mississippi

Last Updated: 12/29/2013

Staff Administration: Code 41-79-5 (2000) authorizes each school district to have employed a school nurse, known as the Health Service Coordinator, in compliance with the school nurse intervention program established by the State Department of Health. The code requires the program offers preventive services that includes assessing, planning, implementing and evaluating programs and other school health activities, in collaboration with other professionals, appropriate to each grade level and the age of maturity of the pupil.
 

Self-Administration of Asthma Medication: Code 41-79-31 (2010) requires local school boards to permit the self-administration of asthma medication by a student provided that written authorization is given by a parent or guardian and a written statement is given by a health care practitioner indicating that the student has received instruction in self-administration. Parents must sign a liability waiver. The code allows students with asthma to possess and use asthma medications when at school, at a school-sponsored activity, and under the supervision of school personnel before or after normal school activities while on school properties.

Section 2 of Code 
41-79-31 (2010) requires the State Department of Education to require each public school district to  recommend that each child with asthma have a current asthma action plan (AAP) on file at the child's school. The AAP should include the child's asthma severity classification, current asthma medication and emergency contact information.

Self-Administration of Anaphylaxis MedicationsCode 
41-79-31 (2010) requires local school boards to permit the self-administration of anaphylaxis medication by a student provided that written authorization is given by a parent or guardian and a written statement is given by a health care practitioner indicating that the student has received instruction in self-administration. Parents must sign a liability waiver. The code  allows students to possess and use anaphylaxis medications when at school, at a school-sponsored activity, and under the supervision of school personnel before or after normal school activities while on school properties.

Psychotropic Medications: No state policy.

Storage and Record-keeping: No state policy.


Montana

Last Updated: 10/11/2013

Staff Administration: Board of Nursing Rule 24.159.1616 allows a nurse to delegate administration of medication in schools. The medications are limited to the types of medicine outlined in the rule.

Self-Administration of Asthma Medication: MCA 20-5-420 (2005) requires schools to permit pupils with asthma to self-administer medication provided that parents given written authorization for the self-administration of medication, the physician provides a written statement, and that documentation of the student's ability to self-administer has filed. The student may possess and administer the medication while at school,  at a school-sponsored activity, while under the supervision of school personnel, while in before or after school activities and while in transit to school or other school-sponsored activities. The law further ensures that the school district and its employees are not liable for any injury resulting from the self-administration of medication by a student.

Self-Administration of Asthma Medication
:
MCA 20-5-420 (2005) requires schools to permit pupils with anaphylaxis to self-administer medication provided that parents given written authorization for the self-administration of medication, the physician provides a written statement, and that documentation of the student's ability to self-administer has filed. The student may possess and administer the medication while at school,  at a school-sponsored activity, while under the supervision of school personnel, while in before or after school activities and while in transit to school or other school-sponsored activities. The law ensures that the school district and its employees are not liable for any injury resulting from the self-administration of medication by a student.

Psychotropic Medications: No state policy.

Storage and Record-keeping: No state policy.


North Carolina

Last Updated: 9/17/2013

Staff Administration: Statute 115C-375.1 allows any teacher or school employee to administer any drugs or medication prescribed by a doctor upon written request of the parents The statute provides for immunity from liability in civil damages for any authorized act or act of omission relating to it, unless the act or omission amounts to gross negligence, wanton conduct or intentional wrongdoing.

Statute 115C-12(31) requires the State Board of Education to develop guidelines for individual diabetes plans.  Some of these requirements include outlining the responsibilities and appropriate staff development for teachers and other school personnel in each student’s individual diabetes plan, as well as information and staff development to be made available to teachers and other school personnel in order to appropriately support and assist students with diabetes. Statute115C-375.2 requires local boards of education to adopt and implement these guidelines.

Self-Administration of Asthma Medication: Statute 115C-375.2 (2005) requires local boards of education to adopt policies authorizing students with asthma to possess and self-administer asthma medication on school property, at school-sponsored events, and in transit to and from school. District policy shall require that written authorization from the student's parent or guardian permitting the self-administration of medication, a written statement from the student's health practitioner verifying the student's health condition and prescription of medication, a written treatment plan for emergency protocol provided by the student's health practitioner, and a written statement by the parents indicating that school employees are immune from any liability for any injury resulting from the self-administration of medication. The student and parent must also provide back-up asthma medication to be kept on file in the school in the event of an emergency.

Self-Administration of Anaphylaxis Medication: Statute 
115C-375.2 (2005) requires local boards of education to adopt policies authorizing students with an anaphylactic reaction to possess and self-administer medication on school property, at school-sponsored events, and in transit to and from school. District policy shall require that written authorization from the student's parent or guardian permitting the self-administration of medication, a written statement from the student's health practitioner verifying the student's health condition and prescription of medication, a written treatment plan for emergency protocol provided by the student's health practitioner, and a written statement by the parents indicating that school employees are immune from any liability for any injury resulting from the self-administration of medication. The student and parent must also provide back-up anaphylaxis medication to be kept on file in the school in the event of an emergency.

Self-Administration of Diabetes Medications
Statute 115C-12(31) requires the State Board of Education to develop guidelines for individual diabetes plans.  Some of these requirements include outlining the responsibilities and appropriate staff development for teachers and other school personnel in each student’s individual diabetes plan, as well as information and staff development to be made available to teachers and other school personnel in order to appropriately support and assist students with diabetes.Although not specifying rules regarding self-administration, Statute115C-375.2 requires local boards of education to adopt and implement these guidelines

Psychotropic Medications: No state policy.

Storage and Record-keeping: No state policy.


 

North Dakota

Last Updated: 12/14/2012

Staff Administration: No state policy.

Self-Administration of Asthma Medication: Code 15.1-19-16 (2005) allows a student who has been diagnosed with asthma to possess and self-administer emergency medication provided that the student's parents file a document that is signed by the health care provider that indicates the student has been instructed in the self-administration of emergency medication, lists the name, dosage, and frequency of  all medication prescribed, and includes guidance for treatment in the event of an asthmatic episode. The law protects a school district or school employee from any liability for civil damages incurred a by student for the self-administered medication.

Staff Administration of Anaphylaxis Medication: Code 15.1-19-16 (2005) allows a student who has been diagnosed with  anaphylaxis to possess and self-administer emergency medication provided that the student's parents file a document that is signed by the health care provider that indicates the student has been instructed in the self-administration of emergency medication, lists the name, dosage, and frequency of  all medication prescribed, and includes guidance for treatment in the event of anaphylaxis. The law protects a school district or school employee from any liability for civil damages incurred a by student for the self-administered medication.

Psychotropic Medications: No state policy.

Storage and Record-keeping: The Health Guidelines for North Dakota Schools (2010) address issues for consideration by school districts, including storage, security and administration. Pursuant to Code 15.1-19-15 (no date available), any records regarding a student obtained by a school must be destroyed when the student reaches the age of eighteen or no longer attends the school, whichever occurs later.


Nebraska

Last Updated: 12/21/2011
check

Medical Emergencies: 92 NAC 59.006 (no date available) requires all schools to adopt and implement the Emergency Response to Life Threatening Asthma or Systemic Allergic Reactions Protocol. This protocol consists of calling for the designated staff to implement the protocol, respiratory evaluation, administration of medications (Epi-Pen), assess the cause and vital signs, contact the parents and physician, and possibly transfer to a medical facility.


Last Updated: 12/21/2011

Staff Administration: Statutes 71-6722 (no date available) and 71-6723 (no date available) and 92 NAC 59.003 (no date available) allows a medication aide to provide oral, inhalation, topical, and instillation into the eyes, ears, and nose medication under the supervision of a health care professional.

Self-Administration of Asthma Medication: Statute 79-224 (2006) requires public and private schools to allow a student with asthma to self-manage his or her asthma. A parent or guardian must provide a written request and authorization from a physician. In addition, the school, parent or guardian and student's physician must develop an asthma medical management plan. The requirements of the plan are outlined in the statute. The statute also states that if a student for whom an asthma medical management plan has been developed injures school personnel or another student as the result of the misuse of prescription asthma medication or related medical supplies, the parent or guardian of the student shall be responsible for any and all costs associated with such an injury. The parent or guardian of the student must also sign a statement that the school and its agents are not liable for any injury or death arising from the student's self-management of asthma, and that they will indemnify and hold harmless the school and its employees and agents against any claim from a student's self-management of his or her asthma condition.

Self-Administration of Anaphylaxis Medication: Statute 79-224 (2006) requires public and private schools to allow a student with anaphylaxis to self-manage his or her anaphylaxis. A parent or guardian must provide a written request and authorization from a physician. In addition, the school, parent or guardian and student's physician must develop an anaphylaxis medical management plan. The requirements of the plan are outlined in the statute. The statute also states that if a student for whom an anaphylaxis medical management plan has been developed injures school personnel or another student as the result of the misuse of prescription anaphylaxis medication or related medical supplies, the parent or guardian of the student shall be responsible for any and all costs associated with such an injury. The parent or guardian of the student must also sign a statement that the school and its agents are not liable for any injury or death arising from the student's self-management of anaphylaxis, and that they will indemnify and hold harmless the school and its employees and agents against any claim from a student's self-management of his or her anaphylaxis condition.

Self-Administration of Diabetes Medication: Statute 79-225 (2006) allows a student to self-administer diabetes medication with the written request of the parent or guardian, authorization of the student's physician, and completion of a diabetes management plan as outlined in the statute.

Psychotropic Medications: No state policy.

Storage and Record-keeping: Statute 71-6724 (no date available) requires a school using the services of a staff member for medication administration to keep and maintain accurate medication administration records. 172 NAC 95.013 (no date available) requires all medications to be stored in secured areas and stored according to the pharmacist's instructions and accessed only by authorized personnel.


New Hampshire

Last Updated: 6/3/2013

Staff Administration: RSA 200:27 (1971) allows school districts to provide school health services that include school nurse and school physician services to every child in the district.

State Board of Education Rule Ed 311.02 (2004) requires local boards to develop policies that incorporate written authorization from a licensed prescriber stating the name, route, and dosage of medication, frequency and time of administration, and possible side effects of adverse reactions, a written request from a parent or guardian that includes emergency contact information, approval of a school nurse to administer the medication, and a list of all the medications. The school nurse also has the responsibility of developing and communicating a system of documenting observations related to the prescriptions.

Self-Administration of Asthma Medication: RSA 200:46 (2003) allows a pupil to possess and use a metered dose inhaler or a dry powder inhaler to alleviate asthma symptoms provided that that pupil's physician and parent/guardian submit written approval. The physician must provide the name, route, and dosage of medication, the frequency and time of medication administration, the date of the order, specific recommendations for administration, any special side effects, contraindications, and adverse reactions, the name of each required medication, and emergency contact information.

Self-Administration of Anaphylaxis Medication: RSA 200:42 (2003) allows a pupil with severe, potentially life-threatening allergies to possess and self-administer an epinephrine auto-injector if written approvals by the pupil's physician and parent or guardian are provided. The approval by the physician must include the pupil's name, the name and signature of the licensed prescriber and business and emergency numbers, the name, route, and dosage of medication, the frequency and time of medication administration, the date of the order, a diagnosis requiring medications, specific recommendations for administration, any side effects, the name of each required medication, and any adverse reactions that may occur to another pupil, for whom the epinephrine auto-injector is not prescribed, should such a pupil receive a dose of the medication.

RSA 200:43 (2003) further instructs the pupil to report to the nurse's office (or principal's office) to enable the nurse to provide appropriate follow-up care immediately after using the epinephrine auto-injector during the school day. RSA 200:44 (2003) requires the school nurse or principal to maintain at least one epipen auto-injector for the student's use in an accessible location if provided by the students.

RSA 200:45 and 200:47 (2003) protect school districts and employees from liability for damages resulting in a pupil's use of an epipen or inhaler, unless the damages were caused by willful or wanton conduct or disregard for the established criteria.

Psychotropic Medications: No state policy.

Storage and Record-keeping: State Board of Education Rule Ed 311.02 requires all prescription medication to be in its original container and stored in a securely-locked cabinet used exclusively for medications. The school nurse is also required to develop a system for documenting and communicating observations relating to medication's effectiveness and adverse reactions.


New Jersey

Last Updated: 10/14/2013

Staff Administration N.J.S.A. 18A:40-1 requires each district board of education to appoint a school physician and at least one certified school nurse to provide nursing services while school is in session. 

State Board of Education Administrative Code N.J.A.C. 6A:16-1.4 (2001) states that each district board of education shall approve written policies and programs governing school functions, which includes the administration of medications to students under a physician's order and emergency administration of epinephrine to a student for anaphylaxis.  It further requires each district board of education to develop and adopt written administration of medication policies and procedures in consultation with a school physician.  New Jersey Administrative Code N.J.A.C. 6A:16-2.1(a) 2 authorizes only the school physician, a certified or non-certified school nurse, a substitute school nurse, the student's parent or guardian, and the student (if approved to self-administer) to administer medication. 

Self-Administration of Asthma Medication: N.J.S.A. 18A:40-12.3 (2007) permits the self-administration of medication for asthma. The parents or guardians must provide written authorization for self-administration of medication, written certification from a physician that the pupil has asthma, written certification of the student's ability to self-administer, and a signed statement exempting the district from liability resulting from injury from self-administration.  N.J.S.A. 18A:40-12.3 (2007) permits a pupil who self-administers medication to carry an inhaler at all times, provided that the pupil does not endanger himself or other persons through misuse.

Self-Administration of Anaphylaxis Medication: N.J.S.A. 18A:40-12.3 (2007) permits the self-administration of medication for a life-threatening allergic reaction.  The parents or guardians must provide written authorization for self-administration of medication, written certification from a physician that the pupil has a potentially life-threatening illness or is subject to a life-threatening allergic reaction, written certification of the student's ability to self-administer, and a signed statement exempting the district from liability resulting from injury from self-administration.  N.J.S.A. 18A:40-12.3 (2007) permits a pupil who self-administers medication to carry a pre-filled auto-injector mechanism at all times, provided that the pupil does not endanger himself or other persons through misuse.

N.J.S.A. 18A:40-12.5 (2007) requires each board of education or chief administrator to develop a policy for the emergency administration of epinephrine via a pre-filled auto-injector mechanism to a pupil for anaphylaxis.  The policy must require the placement of a pupil’s prescribed epinephrine in a secure but unlocked location easily accessible by the school nurse and designees, the school nurse or designee to be promptly available on site at the school and school-sponsored functions in the event of an allergic reaction, and the transportation of the pupil to a hospital emergency room by emergency services personnel after the administration of epinephrine.

N.J.S.A. 18A:40-12.5 (2007) requires each local board or chief administrator to inform parents or guardians in writing that if the administration of epinephrine procedures are followed, the district and its employees shall have no liability as a result of any injury arising from the administration of the epinephrine to the student. The parents or guardians are then required to sign a statement acknowledging their understanding of this statute.

N.J.S.A. 18A:40-12.6 (2007) acknowledges that the school nurse shall have the primary responsibility for the administration of the epinephrine; however, the school nurse shall designate, in consultation with the board of education, or chief school administrator of a nonpublic school, additional employees of the school district or nonpublic school who volunteer to administer epinephrine via a pre-filled auto-injector to a pupil for anaphylaxis when the nurse is not physically present at the scene.

N.J.S.A. 18A:40-12.6c (2007) requires the Departments of Health and Education to develop training protocols for volunteer designees to administer epinephrine in public and non-public schools when the school nurse is not physically present at the scene. 

N.J.S.A. 18A:40-12.7 (1997) each public and nonpublic school shall have and maintain for the use of pupils at least one nebulizer in the office of the school nurse or similar accessible location.  In N.J.S.A. 18A:40-12.8 (2001) the state further requires the State Board of Education, in Consultation with the Commissioner of Health and Senior Services, to adopt regulations requiring each public school board of education to develop policies for the administration of asthma medication through the use of a nebulizer by the school nurse or other person authorized by regulation and require an asthma treatment plan for pupils authorized to use asthma medication.

N.J.S.A. 18A: 40-12.11 (2009) requires that each public school address the management of diabetes in the school setting and establishes that the school nurse is the appropriate personnel to provide care for a student with diabetes, to coordinate the care and educate school staff in the monitoring and treatment of symptoms, develop an individualized health care plan and an emergency health care plan, and consult and coordinate with the student’s parents or guardians and health care provider to establish a safe, therapeutic environment. Management of students with diabetes in the school setting can be accessed at http://www.state.nj.us/education/edsupport/diabetes

N.J.S.A. 18A:40-12.14 (2009) acknowledges the school nurse shall have the primary responsibility for the emergency administration of glucagon to a student with diabetes who is experiencing severe hypoglycemia and also requires the school nurse, in consultation with the board of education, to designate additional employees of the school district who volunteer to administer glucagon when the school nurse is not physically present at the scene. N.J.S. A. 18A: 40-14 further requires that the school nurse or other qualified health care professional train the designated volunteers to be able to administer glucagon. 

The state department of education offers a "Frequently Asked Questions" fact sheet on administration of medication at school.


New Mexico

Last Updated: 10/14/2013

Staff Administration: The New Mexico School Health Manual states that optimally all medications should be administered by a Public Education Department-licensed school nurse. However, in situations where a licensed nurse is not available, the New Mexico Board of Nursing Practice Act allows nurses to delegate or assign to unlicensed persons acts which they are prepared, qualified, licensed or certified to perform. This includes assigning the task of medication administration to an LPN, certified medication aide or other qualified unlicensed person.

Self-Administration of Asthma Medication:
 22-5-4.3 NMSA (2004) requires school discipline policies to allow students to carry and self-administer asthma medication, upon condition of the requirements outlined in the statute. 6.12.2.9 NMAC (2005) requires schools (whether public or nonpublic) to grant to any student in grades K-12 authorization to carry and self-administer health care practitioner prescribed asthma treatment medications if the following conditions are met: (a) the student has demonstrated the necessary skill level for self-administration, (b) there is a written treatment plan for managing asthma episodes of the student, (c) the student's parent or guardian has submitted to the school required documentation outlined in the statute. A school must allow the student to possess and use his/her medication while in school, at a school sponsored-activity, and during normal before- and after- school activities, in transit to school or school-sponsored activities.

Self-Administration of Anaphylactic Medication: 22-5-4.3 NMSA, per SB 275, (2004) allows students to carry and self-administer asthma medication. 6.12.2.9 NMAC (2005) requires schools (whether public or nonpublic) to grant to any student in grades K-12 authorization to carry and self-administer health care practitioner prescribed anaphylaxis emergency treatment medication if the following conditions are met: (a) the student has demonstrated the necessary skill level for self-administration, (b) there is a written treatment plan for anaphylaxis episodes of the student, (c) the student's parent or guardian has submitted to the school required documentation outlined in the statute. A school must allow the student to possess and use his/her medication while in school, at a school sponsored-activity, and during normal before- and after- school activities, and in transit to school or school-sponsored activities. A school must allow the student to possess and use his/her medication while in school, at a school sponsored-activity, and during normal before- and after- school activities, in transit to school or school-sponsored activities.

Psychotropic Medications: New Mexico does not have a state policy; however, the New Mexico Health Services Manual (2004) states that it is preferable that the Public Education Department (PED) licensed nurse administer all student medication, in accordance with the New Mexico Nurse Practice Act. Controlled substances (psychotropic medications) require special attention in the school district's policies.

Storage and Record-keeping: 1.20.2.101 NMAC (2002) requires that student health records must be retained for 10 years after the date of the last entry or until individual attains age 19, whichever is longer. FDA guidelines and national standards recommend that all controlled substances be stored in a double locked narcotic cabinet that is equipped with two separate locks.


Nevada

Last Updated: 10/11/2013

Staff Administration: Nevada does not have a policy specifically addressing the administration of medication. However, NRS 391.208 (2001) does require school nurses to design and carry out nursing services to students with special needs and incorporate instructions from a physician, with the approval of a parent or guardian.

Self-Administration of Asthma Medication: NRS 392.425 (2009) allows allows a student to carry and self-administer medication to treat his asthma while on school grounds, participating in an school activity or on a school bus. In order for a student to carry and self-administer medication, the following must be completed: (1) The parent or legal guardian of a pupil who must submit a written request for self-administration (must include a physician statement of diagnosis, treatment plan, and permission to self-administer), (2) Written authorization from the school for the student to self-administer. The statute also provides for immunity from liability for the injury to or death of a pupil as result of self-administration or the failure of the pupil to self-administer.

Self-Administration of Anaphylaxis Medication: 
NRS 392.425 (2009) allows allows a student to carry and self-administer anaphylaxis medication while on school grounds, participating in an school activity or on a school bus. In order for a student to carry and self-administer medication, the following must be completed: (1) The parent or legal guardian of a pupil who must submit a written request for self-administration (must include a physician statement of diagnosis, treatment plan, and permission to self-administer), (2) Written authorization from the school for the student to self-administer. The statute also provides for immunity from liability for the injury to or death of a pupil as result of self-administration or the failure of the pupil to self-administer.

Self-Administration: NRS 392.425 (2005) allows parents to request authorization from the principal to allow a pupil to self-administer medication for the treatment of asthma or anaphylaxis provided that the self-administration of medication does not create additional duties for school district employees and that these employees are immune from any liability for any injury caused by the self-administration of medication.

Psychotropic Medications: No state policy.

Storage and Record-keeping: No state policy.


New York

Last Updated: 9/22/2013

The Allergy and Anaphylaxis Management Act (2007) requires Commissioners of Health and Education to establish state policy to manage the risk of anaphylaxis in public schools.  The statute requires schools to consider and take action in response to such state policy. The policy must include the following: (1) A procedure and treatment plan for responding to anaphylaxis, including responsibilities for school nurses and other school personnel, (2) A training course for appropriate school personnel for preventing and responding to anaphylaxis, (3) Procedures, guidelines and communication plan for the development of an individualized emergency health care plan for children with a food or other allergy, and (4) Strategies for the reduction of the risk of exposure to causative agents, including food and other allergens.   Making the Difference: Caring for Students with Life-Threatening Allergies (2008) is the guidance document resulting from this legislation.

Education Law 919 (2008) requires every school to make a nebulizer available on-site. Nebulizers must be administered by a school nurse or physician pursuant to a student patient's specific orders.

Self-Administration of Asthma Medication: Education Law 916 (2004) allows students with asthma to carry and use a prescribed inhaler during the school day, with the written permission of a physician or other authorized healthcare provider and a parent/guardian.

Self-Administration of Anaphylaxis Medication: No state policy.

Psychotropic Medications: No state policy.

Storage and Record-keeping: No state policy.


Ohio

Last Updated: 1/5/2011

Staff Administration: ORC 3313.713 (2010) mandates the board of education if each city, local, exempted village, and joint vocational school district to adopt a policy on the authority of its employees when acting in situations other than those governed by sections 2305.23, 2305.231, and 3313.712 of the Revised Code, to administer drugs prescribed to students enrolled in the schools of the district. The policy must contain the following: (1) Except as otherwise required federal law, no person employed by the board shall administer any drug prescribed by any student enrolled in the schools of the district, (2) Designated persons employed by the board are authorized to administer to a student a drug prescribed for the student. Effective July 1, 2011, only employees of the board who are licensed health professionals, or who have completed a drug administration training program conducted by a licensed health professional and considered appropriate by the board, may administer to a student a drug prescribed for the student. Except as otherwise provided by federal law, the board’s policy may provide that certain drugs or types of drugsmay shall not be administered or that no employee may use certain procedures, such as injection, to administer a drug to a student, (3) No drug prescribed for a student may be administered pursuant to federal law until requirements outlined in the statute are completed. The statute provides immunity from liability for authorized employees administering medication, except in cases of gross negligence or wanton or reckless misconduct.

Self-Administration of Asthma Medication: ORC 3313.716 (1999) allows a student to possess and use a metered dose inhaler to alleviate symptoms of asthma if a written statement of approval from a parent or guardian is provided. The statement should include the student's name, address, name and dose of medication, dates administration is to begin and end, adverse reactions, emergency telephone number, and any other special instructions. The code states that any employee of the school is not liable in damages in a civil action for injury, death, or loss to person or property allegedly arising from a school employee's permitting a student to use an inhaler because the employee's good faith that the conditions of the policy have been satisfied.

Self-Administration of Anaphylaxis Medication: ORC 3313.713 (2007) allows students to possess and self-administer an epinephrine auto-injector to treat anaphylaxis at any school event, activity or program under the following conditions: (1) Written approval of the prescriber and parent and/or guardian, with copies submitted to the school nurse or principal (specific requirements of approval outlined in statute), and (2) The school principal or school nurse has received a backup dose of the anaphylaxis medication from the parent, guardian or student, if not a minor. Whenever a student uses an auto-injector at school or any activity, event or program sponsored by or in which the school is a participant, a school employee must request assistance from an emergency medical service provider. The statute provides immunity from liability to school districts and their employees for injury, death or loss to person or property allegedly arising from a student's use of an auto-injector.

Psychotropic Medications: No state policy.

Storage and Record-keeping: See Staff Administration. ORC 4729.01 (2004) requires prescription medications be stored in the original container and in a locked space. ORC 3313.713 (2010) states that the board, or a person designated by the board, must establish a location in each school building for the storage of drugs to be administered under this section and federal law. All such drugs shall be stored in that location in a locked storage place, except that drugs that require refrigeration may be kept in a refrigerator in a place not commonly used by students. If a drug is administered to a student, the board of education must acquire and retain copies of the written requests required by division (C)(1) and the statements required by divisions (C)(2) and (3) of the section and must ensure that by the next school day following the receipt of any such statement a copy is given to the person authorized to administer drugs to the student for whom the statement has been received.


Oklahoma

Last Updated: 9/17/2013

Staff Administration: Statute 70-1-116.2 (1982) allows a school nurse, a nurse employed by a county health department contracted to the school district for medical services, an administrator, or school employee in the absence of a nurse, to administer nonprescription and prescription medications. A designated school employee shall not be liable to the student or a parent or guardian of the student for civil damages for any personal damages resulting from the administration of medication.

Staff Administration of Diabetes Medication: Statute 70-1210.196.1 to 70-1210.196.8 (2007) mandates the development of a diabetes medical management plan for each student who will seek care for diabetes while at school or while participating in a school activity. The school nurse or—if a school does not have a school nurse—other school employees may serve as volunteer diabetes care assistants to assist the student with the management of their diabetes care. The statute requires the State Department of Health to develop guidelines for the training of school volunteer diabetes care assistants. Training should include recognition of hypoglycemia and hyperglycemia, proper glucose target ranges, performance of finger sticks and checking of urine ketone levels, administration of insulin and glucagon, and recommended food intake schedules. School employees are provided immunity from civil liability for actions taken in compliance with the statute.

Self-Administration of Asthma Medication: Statute 70-1-116.3 (2003) requires each school district to adopt a policy permitting self-administration of inhaled asthma medication by a student. The statute requires the authorization of a parent or guardian, a written statement from a physician stating that the student is capable of self-administering the medication, written notification to the parent or guardian that school employees are exempt from liability as a result of any injury from self-administration, and a signed statement by the parent or guardian acknowledging that the school will incur no liability. A student who is permitted to self-administer asthma medication pursuant to this section must be allowed to possess and use a prescribed inhaler at all times.

Self-Administration of Anaphylaxis Medication: Statute 70-1-116.3  (2003) requires each school district to adopt a policy permitting self-administration of anaphylaxis medication by a student. The statute requires the authorization of a parent or guardian, a written statement from a physician stating that the student is capable of self-administering the medication, written notification to the parent or guardian that school employees are exempt from liability as a result of any injury from self-administration, and a signed statement by the parent or guardian acknowledging that the school will incur no liability.  A student who is permitted to self-administer anaphylaxis medication pursuant to this section shall be permitted to possess and use an anaphylaxis medication, including but not limited to an Epinephrine injector, at all times.

HB 1309 (2007) permits a student to attend to the management and care of their diabetes needs.  This includes performing blood glucose level checks, administration of insulin, treating hypoglycemia and hyperglycemia, and possessing necessary supplies and equipment in any area of the school, school grounds or at a school-related activity. It also requires schools to provide a private area where the student may attend to diabetes-related needs.

Psychotropic Medications: No specific state policy.

Storage and Record-keeping: Statute 70-1-116.2 requires schools to keep a record of which student the medicine was administered to, the date of administration, the name of the person administering the medicine, and the type or name of medicine administered. The statute requires that medicine be properly stored and only accessible to the designated officials who are permitted to administer it.

 


Oregon

Last Updated: 10/14/2013

Staff Administration: ORS 339.869 (2013) requires the State Board of Education to adopt guidelines for the administration of prescription and nonprescription medication to students, including training requirements for school personnel.  The statute also requires local school district boards to adopt policies and procedures consistent with these rules.  A school district board shall not require school personnel who have not received appropriate training to administer medication. It also requires the Board to adopt rules for the administration of premeasured doses of epinephrine by school personnel trained as provided by ORS 433.815 to any student or other individual on school premises who the personnel believe in good faith is experiencing a severe allergic reaction, regardless of whether the student or individual has a prescription for epinephrine.  ORS 339.869 (2013) allows a person who has received training according to ORS 433.815 to acquire a premeasured dose of epinephrine for use in cases of emergency administration when a licensed health care professional is not immediately available.

OAR 581-021-0037  (2010),  also requires local districts to develop policies and procedures that provide for 1) the administration of prescription and non-prescription medication to students by trained school personnel, 2) the training of designated staff to administer medication under the written permission of a parent/guardian and instructions from a physician and 3) emergency medical response to life-threatening effects and reactions. 

ORS 339.870 (2001) and ORS 339.871 (2007) exempts school personnel from liability as a result of the administration of prescription  or nonprescription medications, or as a result ofgood-faith assistance of a student’s self-administration of medication, respectively, if the administration or assistance is in accordance with written permission and instructions of the student’s parent, guardian or Oregon licensed health care professional.. 

Self-Administration of Asthma Medication
: ORS 339.866 (2007) requires a school district board to adopt policies and procedures that provide for self-administration of medication for students in grades K-12 with asthma or severe allergies.  Self-administration is permitted in school, at a school-sponsored activity, while under the supervision of school personnel, in before- or after-school programs on school-owned property, and in transit to or from school or school-sponsored activities. The policies and procedures shall: (1) Require prescription, instruction on proper use and a written treatment plan from a health care professional, (2) Require the submission of any written documentation required by the school by parents of a student, including those related to liability, (3) Require the storage of backup medication in a location to which the student has immediate access, and (4) Allow a school to revoke its permission for a student to self-administer medication in cases of irresponsibility or abuse. The statute prohibits a school board from requiring school personnel who have not received appropriate training to assist a student with asthma or a severe allergy with self-administration of medication.

ORS 339.869 (2009) requires the State Board of Education to adopt guidelines for student self-medication. The statute also requires school district boards to adopt policies and procedures consistent with state guidelines. OAR 581-021-0037  (2010) also requires local districts to develop policies and procedures guidelines for self-medication by a student.  These policies must include: safe storage, handling, monitoring supply and disposing of medications; record keeping and reporting of medication administration, including errors in administration; emergency medical response for life threatening side effects and allergic reactions; and student confidentiality.

Self-Administration of Anaphylaxis Medication
: ORS 339.866 (2007) requires a school district board to adopt policies and procedures that provide for self-administration of medication for students in grades K-12 with asthma or severe allergies.  Self-administration is permitted in school, at a school-sponsored activity, while under the supervision of school personnel, in before- or after-school programs on school-owned property, and in transit to or from school or school-sponsored activities. The policies and procedures shall: (1) Require prescription, instruction on proper use and a written treatment plan from a health care professional, (2) Require the submission of any written documentation required by the school by parents of a student, including those related to liability, (3) Require the storage of backup medication in a location to which the student has immediate access, and (4) Allow a school to revoke its permission for a student to self-administer medication in cases of irresponsibility or abuse. The statute prohibits a school board from requiring school personnel who have not received appropriate training to assist a student with asthma or a severe allergy with self-administration of medication.

ORS 339.869 (2009) requires the State Board of Education to adopt guidelines forstudent self-medication. The statute also requires school district boards to adopt policies and procedures consistent with the state guidelines. OAR 581-021-0037  (2010) also requires local districts to develop policies and procedures guidelines for self-medication by a student.  These policies must include: safe storage, handling, monitoring supply and disposing of medications; Record keeping and reporting of medication administration, including errors in administration; emergency medical response for life threatening side effects and allergic reactions; and student confidentiality.

Psychotropic Medications: ORS 339.873 (2003) prohibits a K-12 public school employee from recommending to a parent/guardian that the student seek a prescription for a medication that will affect or alter the thought processes, mood, or behavior of the student. A school employee may also not require a child to obtain a prescription for a substance covered by the federal Controlled Substances Actas a condition of attending school, receiving an evaluation to determine eligibility for early childhood special education or special education, or receiving early childhood special education or special education services.

Storage and Record-keeping: OAR 581-021-0037 requires local districts to develop policies and procedures guidelines for the safe storage and handling of medications and record keeping of administration.

Medical Emergencies: OAR 581-022-0705 requires every school building to have a written plan for responding to medical emergencies. 


Pennsylvania

Last Updated: 12/30/2013

Staff Administration: The Department of Education requires schools to develop policies and procedures for the administration of medication per 022 PA Code 12.41 (2005). The Department of Health provides guidance for schools on the development of this policy in the Guidelines for Pennsylvania Schools for the Administration of Medications and Emergency Care (2010). The Professional Nursing Law and the Practical Nursing Law do not allow nursing functions, including the administration of medication, to be delegated to non-licensed personnel. Consequently, a certified school nurse or other licensed personnel (RN, LPN) cannot lawfully delegate the nursing function of medication administration to the principal, teacher or administrative personnel.  

24 P.S. 14-1414.1 (subsection f, 2010) directs the Departments of Health and Education to provide technical assistance and resources on the administration of allergy medication by school staff, including proper use of epinephrine devices, recognizing symptoms of severe allergic reaction, requirements for proper access, storage, and security; notification of appropriate persons after medication is administered, and recordkeeping.

Guidance on the administration of medication is also included in the School Health Program Manual (2009).

Self-Administration of Asthma Medication
:  24 P.S. 14-1414.1  (2011) requires each school entity to develop a written policy to allow students to possess and self-administer an asthma inhaler in a school setting. The policy shall include a requirement that students must demonstrate competency in the self-administration of medication and responsible use of the medication, as well as specify limitations and conditions under which the student may lose privileges to self-carry and identify a suitable storage location if the student is not allowed to self-carry.  The policy may also include a requirement of a written statement from a healthcare professional that includes essential medication information and a statement whether the student is able to self-administer, as well as a written request from the parent or guardian.

The Guidelines for Pennsylvania Schools for the Administration of Medications and Emergency Care (2010) provide additional guidance to schools for developing policies around self-administration.


Self-Administration of Anaphylaxis Medication:  24 P.S. 14-1414.1 (2011) requires each school entity to develop a written policy to allow students to possess and self-administer an epinephrine auto-injector in a school setting. The policy shall include a requirement that students must demonstrate competency in the self-administration and responsible use of the medication, specify limitations and conditions under which the student may lose privileges to self-carry, and identify a suitable storage location if the student is not allowed to self-carry.  The policy may also include a requirement of a written statement from a healthcare professional that includes essential medication information and a statement whether the student is able to self-administer, as well as a written request from the parent or guardian.

The Guidelines for Pennsylvania Schools for the Administration of Medications and Emergency Care (2010) provide additional guidance to schools for developing policies around self-administration.

Psychotropic Medications: Pennsylvania has no specific state policy concerning psychotropic medications. The Department of Education requires schools to develop their own policies and procedures for the administration of medication per 022 PA Code 12.41 (2005).

Storage and Record-keeping: Pennsylvania has no specific policy on the storage and record keeping of medication. The Department of Education requires schools to develop their own policies and procedures for the administration of medication per 022 PA Code 12.41 (2005). 24 P.S. 14-1414.1 (subsection f, 2010) directs the Departments of Health and Education to provide technical assistance and resources on the administration of allergy medication by school staff, including proper use of epinephrine devices, recognizing symptoms of severe allergic reaction, requirements for proper access, storage, and security; notification of appropriate persons after medication is administered, and recordkeeping.

Medical Emergencies: Pennsylvania has no specific policy on medical emergency plans. However, the Department of Education does require schools to develop their own policies and procedures for emergency care per 022 PA Code 12.41028 PA Code 23.79 (1959) also requires school nurses to develop plans for first aid services.

 


Rhode Island

Last Updated: 8/2/2013

Staff Administration: Statute 16-21-7 (2007) requires all schools to have a school health program to provide nursing care to students by certified nurse teachers at the written request of a physician and the parent or guardian of the student. Section 8.3.2 of the Rules and Regulations for School Health (2009) states that nurse-teacher personnel shall provide health services to school children including the administration of medications.

Section 20.0 of the Rules and Regulations for School Health (2009) requires each public school to develop protocols and procedures related to the administration of medication in schools and requires, at a minimum, for certified school-nurse teacher to administer medications to students in the public school.

Statute 16-21-22 (1998) also requires the state department of elementary and secondary schools and the department of health to develop policies, rules, and regulations pertaining to school health programs addressing procedures of anaphylaxis incidences. The policies should include a procedure whereby a parent may authorize the school department to administer the epinephrine on his or her child in case of an emergency provided that a doctor's letter or prescription notifying the school of the child's allergy and the need for epinephrine in an emergency is given.

Staff Administration of Diabetes MedicationsStatute 16.21.28.2 (2008) requires the Department of Education to incorporate into their policies, rules and regulations for addressing incidents of hypoglycemia resulting in unconsciousness, seizure and/or the inability to swallow in those children medically identified as having diabetes. The policies must include procedures whereby a parent or legal guardian of any child may authorize school employees or those employed on behalf of the school, when there is no school nurse immediately available, to administer glucagon to a child in an emergency, while at school or school sponsored activities. The policies also must require the glucagon to be kept in a conspicuous place, readily available, and provide for administration training by a licensed physician or other medical professional. Staff must be allowed to voluntarily assist with the emergency administration of glucagon when authorized by a parent or legal guardian, after completion of glucagon administration training. A parent or guardian must provide a diabetes management plan or a signed physician’s order prescribing the care and assistance needed.

Statute 16.21.28.2 (2008) states that school employees may not be subject to penalty or disciplinary action for refusing to be trained in glucagon administration. The statute also provides immunity from liability to school personnel and those employed on behalf of the school for “omissions in the use of glucagon which may constitute ordinary negligence.”

Self-Administration of Asthma Medication: Statute 16-21-22 (1998) requires policies allowing children to carry and use prescription medication and inhalers during school and at school functions. A child who needs to carry prescription medication or inhalers must provide the school medical documentation stating that the prescription medication or inhaler has been legitimately prescribed and that the child needs to carry it due to a medical condition. The statute exempts any school teacher, school administrator, or school health personnel from incurring liability for civil damages resulting from acts or omissions in use of the epinephrine or from the use of prescription inhalers by children.

Self-Administration of Anaphylaxis Medication: Although not specifying the administration of epinephrine, Section 20.0 of the Rules and Regulations for School Health (2009) requires school districts to develop protocols and procedures permitting students to self-carry and/or self-administer prescription medication during school and at off-site school sponsored activities provided a written order is given by the prescriber and written authorization is given by the parent/guardian. Section 18.10 of the Rules and Regulations for School Health (2009) states that none of the requirements regarding staff-administration of epinephrine shall preclude the self-administration of an epinephrine auto-injector by a medically identified student.

Psychotropic Medications: No specific state policy.

Storage and Record-keeping: Section 20.5 of the Rules and Regulations for School Health (2009) requires the school nurse-teacher or other registered nurse to document each dose of medication administered or not administered when not done so as ordered. Section 20.6 requires all medications that are to be administered be kept in a secured cabinet.


South Carolina

Last Updated: 10/14/2013

Staff Administration: No state policy.

Self-Administration of Asthma Medication: Code 59-63-80 (2005) requires each school district to adopt a policy, "requiring that students with special health care needs have individual health care plans."  The plans must provide for the "authorization of a student to self-monitor and self-administer medication as prescribed by the student's health care provider unless there is sufficient evidence that unsupervised self-monitoring or self-medicating would seriously jeopardize the safety of the student or others." This policy must include a requirement that the parent or legal guardian to provide the school with written authorization for the student to self-monitor and self-administer medication from themselves and the student's health care practitioner.  The statements must be kept on-file in the school nurses' office or that of the school administrator. A requirement for the authorization to possess on his person and administer while in school, on school grounds, at a school-sponsored activity, in transit to or from school or school sponsored activities, or during before-school or after-school activities on school operated property is also required.

Self-Administration of Anaphylaxis MedicationCode 59-63-80 (2005) requires each school district to adopt a policy, "requiring that students with special health care needs have individual health care plans."  The plans must provide for the "authorization of a student to self-monitor and self-administer medication as prescribed by the student's health care provider unless there is sufficient evidence that unsupervised self-monitoring or self-medicating would seriously jeopardize the safety of the student or others." This policy must include a requirement that the parent or legal guardian to provide the school with written authorization for the student to self-monitor and self-administer medication from themselves and the student's health care practitioner.  The statements must be kept on-file in the school nurses' office or that of the school administrator. A requirement for the authorization to possess on his person and administer while in school, on school grounds, at a school-sponsored activity, in transit to or from school or school sponsored activities, or during before-school or after-school activities on school operated property is also required.

Psychotropic Medications
: No state policy.

Storage and Record-keeping: No state policy.

Medical Emergencies: Regulation 61-42, Section XII (no date available) requires there be at least one full-time staff member or volunteer certified in both first-aid and CPR by the American Red Cross, and capable of recognizing the symptoms of distress.


South Dakota

Last Updated: 1/12/2013

Staff Administration: Statute 13-33A-1 (1993) requires a public school system to provide school health services, including assessments and the implementation of the administration of medications, to be coordinated by a registered nurse.

Self-Administration of Asthma Medication: No state policy.

Self-Administration of Anaphylaxis Medication: No state policy.

Psychotropic Medications: No specific state policy.

Storage and Record-keeping: Statute 13-33A-2 (1993) requires the State Board of Education to have established requirements for storage and control of medications at the school site.


Tennessee

Last Updated: 12/29/2013

Staff Administration:  Code 49-5-415 (2011) states that a local education agency may permit an employee or person under contract to the board to assist in the self-administration of medication if the following conditions are met:  (1) employee providing assistance is a licensed health care professional, (2) the student is competent to administer medication with assistance, (3) the student’s medical condition is stable, (4) self-administration is documented, (5) guidelines for self-administration are followed and parental permission is granted and (6) assistance shall primarily include storage and timely distribution of medication.  Any person providing assistance under these conditions is not liable for injury resulting from “reasonable and prudent” assistance.

Code 49-5-415 (2011) provides for school nurses and other volunteer school personnel who receive appropriate training to assist with the care of students with diabetes.  Both school nurses and trained school personnel may administer Glucagon in emergency situations based on the student’s individual health plan (IHP).  However, if a nurse is available on site, they should provide the service to the student.  A school registered nurse and trained volunteer is not liable for injury resulting from “reasonable” assistance if it has been provided pursuant to the guidelines outlined in the statute.

Code 49-5-415 (2011) requires the department of education to provide guidelines for the management of students with life-threatening allergies. This includes training for school personnel for administration of a cartridge injector for life-threatening food allergies and procedures for school personnel to administer epinephrine when the school nurse is not available.

Code  49-5-415 (2011) requires the department of education to provide guidelines for the management of students with life-threatening allergies.  This includes training for school personnel for administration of a cartridge injector for life-threatening food allergies and procedures for school personnel to administer epinephrine when the school nurse is not available. 

Chapter 1054 of the Public Acts of 2008 amends Code 49-5-415 (2011) and states, “…[P]ublic and non-public school personnel who volunteer…and who have been properly trained by a registered nurse employed or contracted by the LEA…may administer anti-seizure medications, including diazepam gel, to a student in an emergency situation based on that student’s IHP.” 

Self-Administration of Asthma Medication:  Code 49-5-415 (2011) requires districts to permit possession and self-administration of a prescribed, metered dosage, asthma-reliever inhaler by an asthmatic student at school, at a school-sponsored activity or before or after normal school activities while on school properties, including school-sponsored child care or after-school programs.  The student must provide the necessary authorizations from a parent and physician. Districts must inform parents and/or guardians in writing that the school and its employees are not liable as a result of any injury sustained by the student from self-administration. The parents are then required to sign the statement.  Procedural recommendations are further provided in the Tennessee State Board of Education, Guidelines for the Use of Healthcare Professionals and Health Procedures in a School Setting 4.205 (2007).


Self-Administration of Anaphylaxis Medication: Code 49-5-415 (2011) states that a student suffering from anaphylaxis is entitled to possess and self-administer prescription medication on school property or during a school event provided that written authorization is given by the parent, the parent exempts the school district and its employees from any liability, and a written statement outlining the circumstances in which the student shall self-administer and the name of the medication is given by the student’s physician.

Self-Administration of Diabetes Medication: Code 49-5-415 (2011) allows a student with diabetes to perform blood glucose checks, administer insulin, treat hypoglycemia and hyperglycemia, and otherwise attend to the care and management of the student’s diabetes in any area of the school or school grounds and at any school-related activity.  It also allows for the student to possess diabetes monitoring and treatment supplies, including sharps.  The student must have a medical management plan listing the health services needed that is signed by a parent or guardian and signed by a medical professional. 

Psychotropic Medications: Though not exclusively specified, Code 49-5-415 (2011) provides guidelines to assist with students who use medications.

Storage and Record-keeping: Code 49-5-415 (2011) allows a local education agency to permit an employee, or person under contract to the board, to assist in the self-administration of medications so long as the administration is properly documented and the medications are stored. The code further requires any sharps involved in diabetes care and management for a student to be stored in a secure but accessible location, including on the student's person, until use of the sharps is appropriate. 


Texas

Last Updated: 10/1/2010

Staff Administration: The Guidelines for Administering Medications in Schools (no date available) requires students who have a chronic illness or disability to receive medication during the school day. Education Code 38.012 (1999) requires a school district or school to hold a public hearing before health care services are available in the schools. At the hearing, the board will disclose all information regarding proposed health care services.

Self-Administration of Asthma Medication: Education Code 38.015 (2007) entitles students with asthma  to possess and self-administer prescription medication while on school property or at school-related activities, provided that the medication was prescribed for the student, the student has demonstrated to their physician, other health care provider and the school nurse the skill necessary to self-administer, administration is given in compliance with the physician's instructions, a parent submits a written authorization for the student to self-administer, and a statement is provided from a physician or provider stating the student's diagnosis, the name, purpose, prescribed dosage and timeframe of the medication, and circumstances for self-administration.

Self-Administration of Anaphylaxis Medication: Education Code 38.015 (2007) entitles students with anaphylaxis to possess and self-administer prescription medication while on school property or at school-related activities, provided that the medication was prescribed for the student, the student has demonstrated to their physician, other health care provider and the school nurse the skill necessary to self-administer, administration is given in compliance with the physician's instructions, a parent submits a written authorization for the student to self-administer, and a statement is provided from a physician or provider stating the student's diagnosis, the name, purpose, prescribed dosage and timeframe of the medication, and circumstances for self-administration.

Psychotropic Medications: Education Code 38.016 (2003) states school district employees may not recommend that a student use a psychotropic drug. However, this statute does not prohibit school medical staff from recommending that a child be evaluated by an appropriate medical practitioner.

Storage and Record-keeping: No state policy.


Utah

Last Updated: 10/3/2010

Staff Administration: Code 53A-11-601 (1988) allows local school boards to adopt policies designating employees who may administer medication, identify and store medication, train designated employees to administer medication, and maintain records of the administration of medication. Medications may only be administered to a student if: the student's parent has submitted a written request and the student's physician has provided a signed statement. The code further protects school personnel from any civil or criminal liability.

Staff Administration of Anaphylaxis Medication: Code 26-41-104 (2008) requires each primary or secondary school make an emergency epinephrine auto-injector available to any teacher or other school employee who is qualified to administer it. It also requires each school to make initial and annual refresher training regarding the storage and emergency use of an epinephrine auto-injector available to any teacher or other school employee who volunteers to become a qualified adult. Requirements of the training are outlined in the Code. Code 26-41-103 (2008) prohibits a school, school board, or school official from prohibiting or dissuading a teacher or other school employee from completing a training program and/or posessing or storing an epinephrine auto-injector on school property if the requirements outlined in the Code are fulfilled. Those who received training according to Code 26-41-104 (2008) may immediately administer an epipen auto-injector for persons exhibiting symptoms of anaphylaxis at school or a school activity if a school physician is not present according to Code 26-41-105 (2008). State Code 26-41-106 (2008) deems the person who received training under Code 26-41-104 not liable in any civil or criminal action provided that the act was done in good faith under the authority of this code.

R277-611 (2003) prohibits school personnel from requiring a student take or continue to take a specific medication as a condition for attending school or from recommending a single specific health care professional or provider.

Self-Administration of Asthma Medication: Code 53A-11-602 (2004) requires a public school to permit a student to possess and self-administer inhaled asthma medication in school provided that a signed parental statement authorizing the student to self-administer and acknowledging the student's responsibility is given, and a written statement by the student's health care provider prescribing the medical appropriateness for self-administration and the name of the medication authorized for the student's use is also given.

Self-Administration of Anaphylaxis Medication: Code 26-41-104 (2008) requires public schools to permit a student to possess an epinephrine auto-injector or possess and self-administer an epinephrine auto-injector if the student's parent or guardian signs a statement authorizing possession and self-administration of an epinephrine auto-injector, acknowledges that the student is responsible for and capable of possessing and self-administering an auto-injector, and the student's health care provider provides a statement in support of the student posessing and self-administering an epinephrine auto-injector.

Psychotropic Medications: Although not addressing administration of psychogropic medications, Code 53A-11-605 (2007) prohibits school personnel from recommending to a parent or guardian that a child take or continue to take a psychotropic medication as a condition for attending school.

Storage and Record-keeping: Codes 26-41-104 and 53A-11-601 allow local boards to adopt policies for safe-keeping of medications and the maintenance of records of administration.


Virginia

Last Updated: 1/1/2013

Staff Administration: Code 22.1-274 (1990) requires a school board to provide pupil personnel and support services, including student health services. The Manual for the Training of Public Employees in the Administration of Medication states that schools and districts are required to develop their own policies concerning the administration of medications by non-licensed personnel.

Code 54.1-3408 (2012) allows for training programs for those designated to administer medication to students in accordance with school board regulations relating to training, security and record keeping. School nurses are responsible for conducting the training. The Code specifies staff administration only for those drugs normally self-administered by a student.

Code 54.1-3408 (2012) allows a person employed in a school for students with disabilities to administer prescription medication to a student if he or she has satisfactorily completed a training program and has obtained written authorization from a parent or guardian.

Staff-Administration of Diabetes Medication: Code 22.1-274 (1999) requires each school board to ensure that in school buildings with 10 or more administrative and instructional staff, at least two employees have been trained in the administration of insulin and glucagon if there is one or more students diagnosed with diabetes. The code allows for immunity from liability for employees when assisting with administration, and allows employees to refuse to obtain training without penalty. The Department of Education has also produced Manual for Training of Public School Employees in Glucagon and Insulin Administration.

Self-Administration of Asthma Medication: Code 22.1-274.2 (2005) requires local school boards to develop and implement policies allowing students to possess and self-administer inhaler medications  during the school day, at school-sponsored events, or on a school bus or property provided that written consent of the parent and written notification by a primary care physician with instructions are given, approval to self-administer, and an individualized health care plan is developed. Code 8.01-226.5:1 (2000) releases any school employee from liability as a result of supervising the students self-administer asthma medication.

Self-Administration of Anaphylaxis Medication: Code 22.1-274.2 (2005) requires local school boards to develop and implement policies allowing students to possess and self-administer self-injectable epinephrine during the school day, at school-sponsored events, or on a school bus or property provided that written consent of the parent and written notification by a primary care physician with instructions are given, approval to self-administer, and an individualized health care plan is developed. Code 8.01-226.5:1 (2000) releases any school employee from liability as a result of supervising the students self-administer self-injectable epinephrine.  Code  54.1-3408 (2012) allows school board employees, authorized and trained in the administration of epinephrine, to possess and administer epinephrine to any student believed to be having an anaphylactic reaction in accordance with the Code 22.1-274.2 (2005).

Self-Administration of General Medication: The General Guidelines for Administering Medication in School states that school divisions are responsible for making policy concerning self-administration of medications.

Psychotropic Medications: Code 22.1-274.3 (2002) requires the Board of Education to develop and implement policies prohibiting school personnel from recommending the use of psychotropic medications for any student.

Storage and Record-Keeping: The General Guidelines for Administering Medication in School recommends nurses properly store and keep records of medications. The Manual for the Training of Public Employees in the Administration of Medication requires staff members who will administer medications to be able to properly store them and keep records of the administration.

.


Vermont

Last Updated: 8/8/2013

16 VSA 212 (2006) requires the Commissioners of Health and Education to annually inform superintendents and principals of appropriate practices regarding students with life-threatening allergies and chronic illnesses and to prepare and distribute policies, training materials, and school guidelines for managing students with life-threatening allergies and chronic illnesses.  16 VSA 563 (2006) requires local school boards to assign an employee to inform parents of students with life-threatening allergies and chronic illnesses of applicable provisions of Sec 504 of the Rehabilitation Act and other applicable state statutues and rules, to inform appropriate school staff of their responsibilities and provide necessary training.

Staff AdministrationBoard Rule 2120 requires each school to engage the services of a School Nurse or Associate School Nurse, whose duties are to include ensuring appropriate administration of medication. 16 VSA 563 (2006) requires local school boards to assign an employee to inform appropriate school staff of their legal responsibilities to students with life-threatening allergies and life threatening chronic illnesses and to provide necessary training to carry out these responsibilities. The Position Statement Regarding the Administration of Medication on School Field Trips by School Nurses provides guidance for administration on field trips.

Self-Administration of Asthma Medication:  
16 VSA 1387 (2007) requires all public and private schools to allow students with asthma to possess and self-administer emergency medication at school, on school grounds, at school-sponsored, activities, on school-provided transportation, and during school-related programs. Parent/guardians must provide written authorization, liability waiver, and a physician authorization affirming the student has been instructed in proper self-administration techniques. The parent/guardian must develop a plan of action with the school nurse or designated healthcare staff.

Self-Administration of Anaphylaxis Medication
16 VSA 1387 (2007) requires all public and private schools to allow students with life-threatening allergies to possess and self-administer emergency medication at school, on school grounds, at school-sponsored, activities, on school-provided transportation, and during school-related programs. Parent/guardians must provide written authorization, liability waiver, and a physician authorization affirming the student has been instructed in proper self-administration techniques. The parent/guardian must develop a plan of action with the school nurse or designated healthcare staff.

Self-Administration of General Medication:
Board Rule 4222 (2003) requires schools to include in their regulations that a student provide written orders from a physician stating the name of the drug, dosage, time interval the medication should be taken, and the reason for the drug, a written request from the parent or guardian for the school to comply with the physician's orders, the medication to be brought in a pharmacy labeled container, a locked medication storage cabinet, and communication with the parents regarding the effects of the medication for students in need of medications during the school day. 

Psychotropic Medications: 
No state policy.

Storage and Record-keeping: 
Board Rule 4222 requires medication be stored in a locked cabinet.


Washington

Last Updated: 6/18/2009

Staff Administration: RCW 28A.210.260 (2000) instructs the board of directors of a school district to adopt policies addressing the designation of an employee to administer oral medications to students, written request from a parent or guardian, written request from the licensed health professional prescribing the medication, identification of the medication to be administered, safekeeping of the medication, and record keeping of the administration of medication. 

RCW 28A.210.270 (2000) states that the school and its employees are not liable for any criminal action or civil damages from performing the function of administering medication. The code also states that the school, district, and its employees may discontinue the administration of oral medication provided that prior oral or written notification has been given to the parent or guardian.

Staff Administration of Anaphylaxis MedicationSB 6556 (2008) requires the office of the superintendent of public instruction to develop anaphylactic policy guidelines for schools to prevent anaphylaxis and deal wtih medical emergencies resulting from it.  These policy guildelines include responsibilities from school nurses and other appropriate school personnel for responding to a student experiencing anaphylaxis, and the content of a training course for those responding. By September 1, 2009, each school district must develop and adopt a district policy for the prevention of anaphylaxis based on the guidelines in SB 6556 (2008).

Self-Administration of Asthma Medication: RCW 28A.210.370 (2005) requires all districts to adopt policies regarding asthma rescue procedures and authorizing elementary and secondary students with asthma or anaphylaxis to self-administer medication if the following requirements are met: (1) prescription by a health care provider to use during the school day, (2) the health care provider provides a written treatment plan, (3) the student has demonstrated his/her ability to property self-administer the medication, (4) the parent provides written authorization for the student to possess and self-administer medication.

Self-Administration of Anaphylaxis Medication: RCW 28A.210.370 (2005) requires all districts to adopt policies regarding asthma rescue procedures and authorizing elementary and secondary students with asthma or anaphylaxis to self-administer medication if the following requirements are met: (1) prescription by a health care provider to use during the school day, (2) the health care provider provides a written treatment plan, (3) the student has demonstrated his/her ability to property self-administer the medication, (4) the parent provides written authorization for the student to possess and self-administer medication.

Psychotropic Medications: No state policy.

Storage and Record-keeping: No state policy.


Wisconsin

Last Updated: 12/13/2012

Staff Administration: Statute 118.29 (2011) allows several categories of people to administer over-the-counter drugs to a pupil in compliance with written instruction and consent from the parent or guardian and prescription drugs in compliance with instructions from a physician and written consent from the parent or guardian. These include a school bus operator validly authorized to operate the school bus he or she is operating, any school employee or volunteer, county children with disabilities education board employee, or volunteer or cooperative educational service agency employee or volunteer authorized in writing by the administrator of the school district, the board or the agency, respectively, or by a school principal. The statute also authorizes a school bus driver, employee or volunteer to administer glucagon to a known diabetic student who appears to be suffering severe low blood sugar and an automatic epinephrine injector to any student experiencing anaphylaxis.

Self-Administration of Asthma Medication: Statute 118.291 (2009) allows a student with asthma to possess and use a metered dose inhaler or a dry powder inhaler in school, at school-sponsored activities, or under supervision of school authority if written approval and permission are received from the pupil's physician and parent or guardian and given to the principal. The statute further protects the school district, school board or school district employees from civil liability caused by a school employee's good faith belief" that the requirements for a student to use an inhaler were not satisfied or the employee allowed the self-administration of the inhaler based on the good faith belief" that the requirements were satisfied.

Self-Administration of Anaphylaxis MedicationStatute 118.291 (2011) allows a student with severe  allergies to possess and use an epinephrine auto-injector in school, at school-sponsored activities, or under supervision of school authority if written approval and permission are received from the pupil's physician and parent or guardian and given to the principal. No school board, school district, private school, or tribal school, or any employee of the foregoing, is civilly liable for an injury incurred by any of the following: (a) A pupil as a result of using an epinephrine auto-injector under sub. (1r). (b) Any person as a result of a pupil possessing or using an epinephrine auto-injector under sub.

Psychotropic Medications: No state policy.

Storage and Record-keeping: Code PI 8.01 (2004) requires district boards to adopt and implement written policies that contain protocols for the method by which medication administration records are kept. Statute 118.29 additionally requires this policy to include procedures for storing drugs and prescription drugs.

Medical Emergencies: Code PI 8.01 states that policies for emergency nursing services shall include protocols for dealing with pupil accidental injury, illness and administration of medication at all school sponsored activities including but not limited to curricular, co-curricular and extra-curricular activities including a method to record each incident of service provided. The emergency nursing services shall be available during the regular school day and during all school sponsored activities of pupils. Pupil emergency information cards, equipment, supplies and space for the emergency nursing services shall be appropriate and readily accessible.


West Virginia

Last Updated: 3/14/2012

Staff Administration: Code 18-5-22a (no date available) states, "All county boards of education shall develop a specific medication administration policy which establishes the procedure to be followed for the administration of medication at each school".

Board Policy 2422.8 (2004) states prescription medications shall be administered with written authorization from a licensed prescriber and the parent/guardian. This policy also allows for non-certified school personnel, with the proper training, to administer prescription and/or non-prescription medications.

Self Administration of Asthma Medication: Board Policy 2422.8 and Code 18-5-22b (no date available) states that self-administration of asthma medication is permitted when written authorization is received from the parent/guardian, a written statement by the licensed prescriber is received explaining the circumstances and appropriate usage of the medication, and the parent/guardian has given written acknowledgement exempting the school board and its employees of any liability from any injury arising from self-administration. Self-administration of prescribed medication includes medication for emergency and acute situations, such as a rescue inhaler.

Board Policy 2422.7 (2004) requires a health care plan to be prepared by the certified school nurse based on the assessment of a student and/or a physician's written order. The rule also requires confidentiality of all records, logs including the date and time procedures were performed, and the signature of the person administering the medicine to be maintained for each student needing specialized health care procedures.

Self-Administration of Anaphylaxis Medication: Board Policy 2422.8 (2004) allows students to self-administer prescribed emergency or acute medications, such as an Epi-pen, when the prescription indicates that the student must maintain possession of the medication.

Psychotropic Medications: There is no specific state policy for the administering of psychotropic medications. However, Board Policy 2422.8 states that prescription medications will be administered with written authorization from a licensed prescriber and the parent/guardian.

Storage and Record-keeping: Board Policy 2422.8 requires schools to designate space in the building to store student medication at the correct temperature, in a secure, locked, clean cabinet or refrigerator, as required. These medications are to be entered on a medical inventory and all circumstances, orders received, actions taken, and student's status must be documented. 

 


Wyoming

Last Updated: 8/30/2013

Staff Administration: Rule 4362, Chapter VI, Section 17 (2001) requires school districts to provide for the safe handling, storage, and administration of both prescription and over-the-counter medications.

Self-Administration of Asthma Medication: Statute 21-4-310 (2007) requires district school boards to allow students to possess and self-administer medication including asthma inhalers required for potentially life-threatening conditions within any school of the district.  The following conditions must be met:(1) A written statement containing parental verification of ability to self-administer and authorization to self-administer as necessary, and (2) Health care provider identification of the medication prescribed or authorized and verification of the appropriateness of possession and self-administration for the student. “Potentially life-threatening conditions" includes, but is not limited to, asthma, food allergies and insect bites.

Self-Administration of Anaphylaxis Medication: Statute 21-4-310 (2007) requires district school boards to allow students to possess and self-administer medication including epinephrine pens required for potentially life-threatening conditions within any school of the district.  The following conditions must be met: (1) A written statement containing parental verification of ability to self-administer and authorization to self-administer as necessary, and (2) Health care provider identification of the medication prescribed or authorized and verification of the appropriateness of possession and self-administration for the student.

Psychotropic Medications: No state policy.

Storage and Record-keeping: Rule 4362, Chapter VI, Section 17 requires school districts to provide for the safe handling, storage, and administration of both prescription and over-the-counter medications.


Print Page

Click the Print button to print only the content portion of the page. The left menu area and top header will not be printed