State Policies on Administration of Medication in Schools
State Policies on Administration of Medication in Schools
For the most up-to-date information on medication administration in schools, please visit: http://nasbe.org/healthy_schools/hs/bytopics.php?topicid=4110&catExpand=acdnbtm_catD
Alabama
Administrative Code 610-X-6.06 (2001) 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 twenty-four hour course of instruction.
Alaska
Alaska does not have a policy regarding the administration of medications.
Arizona
Revised Statute 15-344 (2002) gives school districts the responsibility of establishing policies and procedures regarding the administration of prescription medication to students by school employees.
Arkansas
Arkansas Code 6-17-102 (1977) [Note: This link is to the general Arkansas Code and users will need to search on the specific number provided] requires all public elementary and secondary schools to employ at least one person who is certified by the American Red Cross or deemed qualified by the Arkansas Department of Education to administer emergency first aid to be on school grounds during normal school hours.
Administrative Rule, Act 355 (1991) states that indications of disabilities or chronic illnesses, regularly prescribed medication, and hospital and doctor preferences must be included in a student's health record.
California
Education Code 49400 (no date available) allows school districts to employ properly certified personnel to care for the health and physical development of students. More specifically, California Code of Regulations Title 5, Division 1, Chapter 2, Subchapter 3, Article 1.4, 600 (2003) [Note: This link is to the general California Code of Regulations and users will need to search on the specific number provided] states 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 codes 601-604 of the CCR.
Education Code 49423 (no date available) allows students to take prescription medication with the assistance of a school nurse or designated personnel, provided that a written statement from a physician detailing the method, amount, and time schedules for the administration of medication, and a written statement from the parent or guardian authorizing the school district to administer the medication to school administrators.
California Code of Regulations Title 5, Division 1, Chapter 2, Subchapter 3, Article 4.1, 605 (2003) [Note: This link is to the general California Code of Regulations and users will need to search on the specific number provided] also allows a pupil to carry medication and self-administer medication and authorizes the local education agency to establish rules governing self-administration.
California Education Code 49414 (no date available) 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.
California Code of Regulations Title 5, Division 1, Chapter 2, Subchapter 3, Article 4.1, 606-609 (2003) [Note: This link is to the general California Code of Regulations and users will need to search on the specific number provided] provides further instruction on the delivery and storage of medication, documentation of the administration of medication, significant deviation from authorized health care provider's written statement, and rules pertaining to unused, discontinued and outdated medication.
Colorado
Colorado has no state law or administrative rule that addresses the administration of medication. The state does, however, provide a sample policy and a sample regulation as guidelines for school districts to follow.
Connecticut
10-212a-2 (1995) (CGS) states that the administration of medications in schools is not a requirement. If the local or regional board allows the administration of medication, no medication may be administered by licensed personnel or designated staff without the written consent of an authorized prescriber and a parent or guardian.
With local board of education approval, students who are able to self-administer medication may do so with a written order from an authorized prescriber, written authorization from a parent or guardian, evaluation from the school nurse, communication with the principal and teachers, and continued possession of the medication under the student's control according to 10-212a-4 (1995) of the Regulations of Connecticut State Agencies.
10-212a-5 (1995) of the Regulations of Connecticut State Agencies requires all medication, except those approved for self medication, to be stored in a designated locked container, cabinet or closet with limited access by authorized personnel. Further, all medication shall be stored in its original container and removed from storage areas when unused, discontinued or obsolete.
Each school administering medication is required to maintain a record for each student that includes the name of the student, the medication, the authorized prescriber, the dosage of medication, the route and frequency of administration, the date the medication was ordered, quantity received, and the date the medication is to be reordered per 10-212a-6 (1995) of the Regulations of Connecticut State Agencies.
Delaware
Administrative Code 14:817 (2003) allows the administration of prescription and non-prescription medication by a school nurse if the following conditions are met: 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, all medication are counted and reconciled at least once a month and kept under double lock, a daily log is maintained with the student's name, time, and date, and annual reauthorization of long-term medication is conducted.
The Code also allows employees of a school district to assist a student with medication on a field trip provided that a written request by a parent/guardian is given with clear instructions of time, dosage, and method of administration indicated, the medication is in a clearly labeled container with the student's name, name of medication, the dose, the time and method of administration, the employee completes a Board of Nursing approved training course conducted by a registered nurse employed by the school district, a record is maintained by each school district for all students receiving medication, and no school employee, except a school nurse, should be compelled to assist a student with medication.
Administrative Code 14:876 (1999), Section 3.12 requires each school district to have a policy that permits the possession of an 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.
Florida
Statute 1006.062 requires local districts to adopt policies governing the administration of medication to include the following provisions: a written statement by a parent or guardian granting permission for a designated school employee to administer medication, the storage of each medication in its original container, securely locked in a location designated by the principal when not in use.
Statutes 232.47 (2001) and 1002.20 (2002) allow students with asthma to carry a metered dose inhaler in school when written approval from a parent and physician is given.
Georgia
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 provides suggested models for each school system to implement the rule. Each model includes administration of medication as a school nurse function.
Georgia Code 20-2-774 (no date available) 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.
Hawaii
Administrative Rule 11-146-3 (1983) permits the school health aide to store or administer oral and topical physician prescribed medication, provided that a request is made from the parent or guardian and approved by the department of health. Further, the medication shall be sent by the parent or guardian in a properly labeled container with the child's name, name of the medication, dosage, time to be given and name of prescribing physician.
Rule 11-146-3 also requires the school health aide to maintain a confidential school record of each student.
Idaho
Idaho does not have a policy regarding the administration of medications.
Illinois
23 Illinois Administrative Code Ch. 1, S. 1.760, Subchapter a outlines the duties 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.
Statute 105 ILCS 5/10-20.14b (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.
Statute 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 92-0402 (2001) 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 physician, physician assistant, or advanced practice registered nurse containing 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 act, 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.
Indiana
Indiana Code 20-8.1-7-5 (2001) 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.
Indiana Code 34-30-14-1 (1998) states that the school board may not require school personnel who are not employed as a school nurse or physician to administer medication to pupils.
Indiana 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.
Indiana Administrative Code 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.
Indiana Code 20-1.8-5.1-7.5 (2001) 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.
Indiana 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.
Iowa
Administrative Code 281.41.12(11) (1999) requires institutions providing special education services 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.
Kansas
Kansas has no state law or administrative rule that addresses the administration of medication in schools.
Kentucky
Revised Statute 156.502 (2002) requires health services to be provided in a school setting by a licensed physician, registered nurse, or a delegated school employee who has been trained by a physician or nurse. Health services are defined in the statute as providing direct health care, including the administration of medication.
Revised Statute 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 health practitioner, that includes the name and purpose of the medication, the prescribed dosage, time the medication is to be administered, and the length of time of the prescription. Parents and guardians are to be given notification that the school will incur no liability against any claims regarding the self-administration of asthma medications by the student.
Revised Statute 158.836 (2002) further 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. The written statement by the healthcare practitioner must contain the name and purpose of the medications, the prescribed dosage, the time the medications are to be regularly administered and under what special circumstances, and the length of time for which the medications are prescribed. The statute further requires school districts to inform the parent or guardian of the student that the school and its employees are not liable from any injury sustained by the student from the self-administration of the asthma medications. The parent or guardian is required to sign a statement acknowledging that the school is not liable to any claims relating to the self-administration of asthma medications.
Louisiana
Revised Statute 17:28 (1995) requires each school system to employ at least one school nurse certified by the State Board of Elementary and Secondary Education 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 Administrative Code 28:929 (page 42) (2001), the state policy on medication, to ensure the health, safety, and welfare of the students.
Revised Statute 17:436.1 (2001) requires all medication administered to students in the public school setting to have a doctor'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.
Maine
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.
Maine does not have a specific policy on the administration of medication in schools.
Maryland
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. Lastly, the regulation requires the board and the health department to formulate policies regarding the storage and administration of medication during school hours and during school-sponsored activities.
Regulation 10.27.11.05 (1994) states that medication administration is a nursing task that may be delegated to an unlicensed individual in the school setting.
Regulation 10.39.01.10 (no date available) requires an individual who performs the delegated nursing function of medication administration to successfully complete a 16-hour medication assistant training program approved by the Maryland Board of Nursing and be registered as a medication assistant by the Board. A registered nurse authorized by the Board must teach this course. The medication assistant must renew this registration every two years.
Massachusetts
Education General Law 71:54B (2002) authorizes the state department of public health to establish regulations governing the administration of medications in school settings. The law also clarifies that school districts may not prohibit students with asthma or other respiratory diseases from possessing and self-administering prescription inhalers.
Massachusetts Department of Public Health Regulation 105 CMR 210.003 (1994) mandates school committees (local boards of education), in consultation with their local boards of health, to adopt policies and procedures governing the administration of prescription medications and self administration of prescription medications within the school system. These policies should include the designation of a supervising school nurse, documentation of the administration of prescription medications, response to a medication emergency, storage of prescription medications, reporting and documenting of medication errors, dissemination of information to parents and guardians, and procedures for the resolution of questions between parents and the school.
Public Health Regulation 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.
Regulation 105 CMR 210.006 (1994) allows the self administration of medication by students 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.
Michigan
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.
Revised School Code 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.
Revised School Code 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 [no direct link available] that also recommends that each school district develop, adopt, and implement a school health services program that includes emergency/urgent care, medication administration, case management for students with chronic health conditions, and a host of preventative services as part of a Comprehensive School Health Program.
Minnesota
Statute 121A.21 (2001) requires every school district to provide services to promote the health of students. At minimum, a school district with 1,000 students or more must employ one full time licensed school nurse.
Statute 121A.22 (2001) 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. Further, the statute allows prescription asthma medications 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.
Mississippi
Public Health Code 41-79-1 (1988) states that a school nurse can provide preventive health services to students to facilitate optimal development and prevent serious health problems.
Public Health Code 41-79-3 (2000) requires 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.
Public Health Code 41-79-31 (2003) states that the school board of each local public school district shall permit the self-administration of 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, states the name and purpose of the medication, the dosage, the time the medication is to be administered, and the length of time for which the medication is prescribed.
Missouri
Revised Statute 167.621.1 (2002) requires parental authorization before providing health services. 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.
Revised Statute 167.627.1 (2002) permits the self-administration of a metered-dose inhaler by a pupil for asthma provided written authorization has been given by the parents or guardians, written certification from a physician is provided, the board informs parents that its employees are exempt from liability as a result of any injury arising from the self-administration of medication, and the parents sign a statement acknowledging the district's exemption from liability.
Revised Statute 168.171 (2002) allows school boards employing thirty or more teachers to employ a supervisor of health and one or more school nurses to serve under the superintendent of schools of the district.
Montana
Montana does not have a policy regarding the administration of medications.
State Code 20-3-324 (1997) does, however, give a physician or a registered nurse the responsibility to inspect the sanitary conditions of a school or the general health conditions of each pupil, and make health records available to any parent or guardian upon request.
Nebraska
Statutes 71-6722 (1998) and 71-6723 (1998) 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. The medication aide is also required to keep and maintain accurate medication administration records per Statute 71-6724 (1998).
Nebraska Department of Health and Human Services Administrative Rule 172-95.013 (1999) requires all medications to be stored in secured areas and stored according to the pharmacist's instructions and accessed only by authorized personnel.
Administrative Rule 172-95.003 (1999) outlines the requirements for self-administration of medication to a person at least 19 years of age or a minor taking their own medication with monitoring of a caretaker, a person who is able to apply a dose of medication according to specific prescribed directions, and a person who is able to recognize any effects associated with the dose of medication.
Administrative Rule 92-59.006 (2000) 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 (EpiPen), assess the cause and vital signs, contact the parents and physician, and possibly transfer to a medical facility.
Nevada
Nevada does not have a policy specifically addressing the administration of medication. However, Revised Statute 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.
New Hampshire
Rule 311.02 (1996) requires 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 rule further requires all prescription medication to be in its original container and stored in a securely-locked cabinet used exclusively for medications. The school nurse also has the responsibility of developing and communicating a system of documenting observations related to the prescriptions.
RSA 200:42 (2003) allows a pupil with severe, potentially life-threatening allergies to possess and self-administer an epinephrine auto-injector if written approval 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 200:45 (2003) states that no school district or district employee is liable in a suit for damages as a result of a pupil’s self-administration of an epinephrine auto-injector.
New Jersey
New Jersey Department of Education Administrative Code 6A:16-1.4 (no date available) 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 via epipen to a student for anaphylaxis.
New Jersey Statute Amended 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. The state further requires in Statute Amended 18A:40-12.8 (2001) 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.
New Jersey Department of Education Administrative Code 6A:16-2.1 (no date available) requires that each district board of education shall appoint at least one school physician, one full time equivalent certified school nurse to provide nursing services, and develop a school nursing services plan assigning a noncertified nurse to perform duties permitted under their license from the State Board of Nursing.
New Jersey Statute Amended 18A:40-3.3 (1999) requires that a school district may only employ a person as a school nurse who holds an educational certificate with an endorsement as a school nurse,. "except for those non-nursing personnel who are otherwise authorized by statute or regulation to perform specific health related services. Special education students and those with medical needs requiring specialized care shall have that care rendered by an appropriate provider as appointed by the [local] Board of Education."
The state department of education offers a "Frequently Asked Questions" fact sheet on administration of medication at school in the School Health Services Guidelines.
New Mexico
School districts are required to provide health services according to State Board of Education Administrative Code 6.30.2.11 (1996). State Department of Health Administrative Code 7 NMAC 12.2.35 (2001) only allows a licensed nurse or physician the authority to administer medications.
New York
New York State provides non-mandatory Administration of Medication in the School Setting Guidelines (2002) that each local district is encouraged to follow.
Education Law 16, Article 19, Section 916 (no year available) allows students with asthma to carry and use a prescribed inhaler during the school day, with the written permission of a physician and a parent/guardian.
North Carolina
North Carolina does not have a state policy regarding administration of medications at school.
North Dakota
North Dakota does not have a policy addressing the administration of medications in schools.
Ohio
Revised Statute 3313.713 (1998) mandates the board of education to adopt a policy authorizing its employees to administer prescription drugs to students enrolled in the schools of its district. The statute further outlines the following requirements for administering drugs: a written statement from a parent or guardian, a signed statement from a physician that includes the student's name, name of the drug, dosage, dates administration is to begin and end, possible adverse reactions, and special storage instructions for the drug; and an original container for each drug which will be stored in an inaccessible location.
Revised Statute 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.
Oklahoma
Statute 70-1-116.2 (1984) designates a school nurse, or an administrator or school employee in the absence of a nurse, to administer nonprescription and prescription medications. Each school is also required 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.
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.
Oregon
Revised Statute 339.869 (1997) requires the State Board of Education to adopt guidelines for local school districts regarding the administration of prescription and nonprescription medication to students, for self-medicating students, and training requirements for school personnel. Further guidance is given in Administrative Rule 581-021-0037 (1999) which requires local districts to develop policies and procedures that provide for the training of designated staff to administer medication under the written permission of a parent/guardian and instructions from a physician, guidelines for self-medication by a student, safe storage and handling of medications, record keeping of administration, emergency medical response to life-threatening effects and reactions, and student confidentiality.
Revised Statute 339.870 (2001) exempts school personnel from liability in a criminal action or civil damages as a result of the administration of prescription and nonprescription medications to a pupil if administered in accordance with written permission and instructions from a parents or guardian.
Pennsylvania
The Department of Education requires schools to develop policies and procedures for the administration of medication per code 22 PA Code Chapter 7, Subchapter B, Subsection 7.13(7) (1987).
House Bill No. 1113 (2003) requires each school entity to develop a written policy to allow for school students to possess and self-administer an asthma inhaler and prescribed medications in a school setting. The policy shall include a requirement that students must demonstrate competency for the self-administration of medication and for responsible behavior. The policy may also include a requirement of a written statement from the physician, which includes the name of the drug, the dose, the times when the medication is to be taken, and the diagnosis, and a written request from the parent or guardian.
Rhode Island
Statute 16-21-7 (no date available) 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 7.2.3.1 of the Rules and Regulations for School Health states that nurse-teacher personnel shall provide health services to school children including the administration of medications.
Statute 16-21-22 (1998) 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. The statute further 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.
South Carolina
The Nursing Practice Act Code 91-1.A (2002) defines the role of a professional nurse to include the supervision and delegation of the administration of medication.
South Dakota
Statute 13-33A-1 (no date available) 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.
Tennessee
Tennessee Code 49-3-359 (1996) provides funding to public school systems for school nurses at the ratio of one per 3,000 students or one per school system, whichever is greater, and allows school systems to employ school nurses or contract them through the Public School Nurse program established in Tennessee Code 68-1-1201 (1988).
Tennessee Code 49-5-415 (2002) of the Tennessee Department of Health establishes the state policy on the administration of medication. However, procedural recommendations of documenting each dosage of medication, maintaining a properly pharmacy labeled container, and written permission from a parent or guardian to administer medications during school hours are provided in the Guidelines for Use of Health Care Professionals and Health Care Procedures In a School Setting (2003).
Code 49-5-415 and the Guidelines for Use of Health Care Professionals and Health Care Procedures In a School Setting permit school employees to assist students in self-administration of medication provided that the student is competent to self-administer, written permission is given by the parent or guardian, self-administration is properly documented, and assistance in storing and distributing the medication is done in a timely manner.
Texas
Texas 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.
TEC 38.013 (2001) 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, administration is given in compliance with the physician's instructions, and a parent submits a written statement from the physician stating that the student is capable of self-administering the medication, and the time and dosage of the medication.
Utah
State Code 53A-11-601 (1988) requires 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: 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.
State Code 26-41-104 (1998) allows each school to designate one or more school personnel to receive initial and annual refresher training regarding the storage and emergency use of an epinephrine auto-injector used for emergency allergic reactions.
Vermont
State Board Rule 4222 (1987) requires schools to 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.
Virginia
Code of Virginia 22.1-274 (1990) requires a school board to provide pupil personnel and support services, including student health services.
Code of Virginia 22.1-274.2 (2000) requires local school boards to develop and implement policies allowing students with asthma 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, and an individualized health care plan is developed.
Code of Virginia 8.01-226.5:1 (2000) releases any school employee from liability as a result of supervising the students self-administer asthma medication.
Washington
Revised Code 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.
Revised Code 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.
West Virginia
Board of Education Legislative Rule 126-25 (2001) 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, a log including the date and time procedures were performed, and a signature of the person administering the medicine to be maintained for each student needing specialized health care procedures.
Wisconsin
Statute 118.29 (2001) allows 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," may 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.
Statute 118.291 (2001) 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.
Wyoming
Statute 35-1-701 (no date available) establishes a joint committee on school health comprised of the state department of education and the state department of health. In Statute 35-1-702 (no date available), the joint committee is to provide policies regarding medical services, sanitary environments, and school health instruction.