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).
Administrative Code 12 AAC 44.965 (2013) 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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
Idaho does not have a policy regarding the administration of medications.
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.
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 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.
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.
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.
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.
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.
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.
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).
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).
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.
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Statute 115C-307 (2000) allows any teacher or school employee, when given authority by the board of education or its designee, to administer any drugs or medication prescribed by a doctor upon written request of the parents. 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 in the case of an emergency and to perform any other first aid or lifesaving techniques in which the employee has been trained in a program approved by the State Board of Education. 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.
North Dakota does not have a policy addressing the administration of medications in schools.
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.
Statute 70-1-116.2 (1982) allows 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. Further, 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.
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.
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.
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.
South Carolina does not have a policy addressing the administration of medications in schools.
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.
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.”
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.
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.
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.
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.
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.
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.
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.
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.