Code: JHCD-AR
Adopted: 3/24/03; 3/12/07
Orig. Code(s): 750.4
Revised: 3/26/07; 1/28/08
Administering Noninjectable Medicines to Students
Definitions
"Prescription Medication" means any non-injectable drug, chemical compound, suspension or preparation in suitable form for use as a curative or remedial substance taken either internally or externally by a student under the written direction of a physician. Prescription medication does not include dietary food supplements.
"Non-prescription Medication" means only commercially prepared, non-alcohol-based medication to be taken at school that is necessary for the student to remain in school. This shall be limited to eyes, nose and cough drops, cough suppressants, analgesics, decongestants, antihistamines, topical antibiotics, anti-inflammatories and antacids that do not require written or oral instructions from a physician. Nonprescription medication does not include dietary food supplements.
"Physician" means a doctor of medicine or osteopathy, a physician assistant licensed to practice by the Board of Medical Examiners for the State of Oregon, a nurse practitioner with prescriptive authority licensed by the Board of Nursing for the State of Oregon, a dentist licensed by the Board of Dentistry for the State of Oregon, and optometrist licensed by the Board of Optometry for the State of Oregon or a naturopathic physician licensed by the Board of Naturopathy for the State of Oregon. "Physician" also may include individuals licensed in the categories set out above by comparable licensing agencies in adjoining states.
"Student self-medication" means a student must be able to demonstrate the ability, developmentally and behaviorally, to administer medication to himself or herself without requiring a trained school staff member to assist in the administration of the medication.
"Training" means the instruction to be provided to designated school staff on the administration of prescription and nonprescription medication, based on requirements set out in guidelines approved by the Department of Education, including discussion of applicable district policies, procedures and materials.
"Parent", as used in this administrative regulation, includes legal guardian or person in a parental relationship. The status and duties of a legal guardian are defined in ORS 125.005(4) and 125.300-125.325. The determination of whether an individual is acting in a parental relationship, for purposes of determining residency, depends on the evaluation of the factors listed in ORS 419B.373. The determination for other purposes depends on evaluation of those factors and a power of attorney executed pursuant to ORS 109.056.
Designated School Staff/Training
The building principal will designate school staff authorized to administer medication to students within individual school buildings and while participating at school-sponsored activities on or off district property. The building principal will ensure building and activity practices and procedures are consistent with the requirement of law, rules and this regulation.
The building principal will ensure the training required by law and Oregon Administrative Rules is provided. Training may be conducted by any physician licensed by the State of Oregon, a nurse licensed by the Board of Nursing of the State of Oregon or by others as deemed appropriate by the district in accordance with training program guidelines recognized by the Department of Education.
Training will provide an overview of applicable provisions of Oregon law, administrative rules, district policy and administrative regulations and include, but not be limited to the following:
1. Safe storage;
2. Handling;
3. Monitoring medication supplies;
4. Disposing of medications;
5. Record keeping; and reporting of medication administration and errors in administration;
6. Emergency medical response for life threatening side effects and allergic reactions; and
7. Student confidentiality.
Materials as recommended and/or approved by the Department of Education will be used.
Training will be provided upon initial assignment to designated school staff authorized to administer medication to students. Subsequent training will be provided as necessary to meet changes in Oregon law, rules, training guidance or as otherwise deemed appropriate by the district.
A copy of the district’s policy and administrative regulation will be provided to all school staff authorized to administer medication to students and others as appropriate.
Staff Administered Medications
Requests for designated school staff to administer medication to students may be approved by the district as follows:
1. A written request for the district to administer prescription medication must be submitted to the school office to include:
a. The written signed permission of the parent;
b. The written instruction from the physician for the administration of the prescription medication to the student including:
1. Name of the student;
2. Name of the medication;
3. Route;
4. Dosage;
5. Frequency of administration; and
6. Other special instruction, if any.
The prescription label will be considered to meet this requirement if it contains the information listed in #1-6 above.
2. A written request for the district to administer nonprescription medication must be submitted to the school office to include:
a. The written signed permission of the parent;
b. The written instruction from the parent for the administration of the nonprescription medication to the student including:
1. Name of the student;
2. Name of the medication;
3. Route;
4. Dosage;
5. Frequency of administration;
6. Other special instruction, if any.
3. Medication is to be submitted in its original container;
4. Medication is to be brought to and returned from the school by the parent;
5. It is the parent’s responsibility to ensure that an adequate amount of medication is on hand at the school for the duration of the student’s need to take medication;
6. It is the parent’s responsibility to ensure that the school is informed in writing of any changes in medication instructions;
7. In the event a student refuses medication, the parent will be notified immediately. No attempt will be made to administer medication to a student who refuses district administered medication;
8. Any error in administration of medication will be reported to the parent immediately and documentation made on the Student Medications Incident report form. Errors include but are not limited to administering medication to the wrong students, administering the wrong medication, dose, time, route, etc.;
9. Medication shall not be administered or self-medication allowed until the necessary permission form and written instructions have been submitted as required by the district;
10. The parental consent is not required for medications prescribed under ORS 109.640 to 109.660 (Rights of Minors to Medical Treatment – Birth Control; Venereal Disease), but the doctor’s request must so state.
Self-medication
Grades K-8: Self-medication of prescription and nonprescription medication is only allowed in cases where a student must carry such medication on his/her person for immediate access and the necessary permission form and written instructions have been submitted as required in 4.2 below (i.e., asthma or severe allergies). Permission for self-administered medication may be revoked at any time if the student violates policy or medical protocol.
Grades 9-12: Self-medication of prescription and nonprescription medication may be allowed subject to the following:
1. Students who are developmentally and/or behaviorally able, will be allowed to self-administer prescription and nonprescription medication, subject to the following:
a. A permission form must be submitted for all self-medication of all prescription and nonprescription medication;
Self administration of prescription medication requires permission from parent, school administrator and physician. Physician consent is to be included on the prescription label or on the medication consent form;
Self administration of nonprescription medication requires permission from parent and school administrator;
Administrator will determine if student may carry self-administered medication or if the medication will be kept in the office;
The parental consent is not required for medications prescribed under ORS 109.640 to 109.660 (Rights of Minors to Medical Treatment – Birth Control; Venereal Disease), but the doctor’s request must so state. Administrator and physician consent still applies.
b. All prescription and nonprescription medication must be kept in its appropriately labeled, original container as follows:
Prescription labels must specify the name of the student, name of the medication, dosage, route, and frequency or time of administration and any other special instructions. Physicians consent for self administration is to be on the label or on the medication consent form.
c. Students who are developmentally and/or behaviorally unable to self-medicate will be provided assistance by designated school staff. A permission form and written instructions will be required as described under the heading: "Staff Administered Medications, paragraphs 1 and 2."
d. Sharing and/or borrowing of medication with another student is strictly prohibited.
e. Permission to self-medicate may be revoked if the student violates the Board’s policy governing Administering Non-injectable Medicines to Students and/or these regulations. Additionally, students may be subject to discipline, up to and including expulsion as appropriate.
Storage, Handling and Monitoring of Medication Supplies:
Medication administered by designated school staff must be delivered by the parent to the school, in its original container, accompanied by the permission form and written instructions, as required above.
1. Medication in capsule or tablet form and categorized as a sedative, stimulant, anti-convulsant, narcotic analgesic or psychotropic medication will be counted by designated school staff in the presence of another school employee upon receipt, documented in the student’s medication log and routinely monitored during storage and administration. Discrepancies will be reported to the building principal immediately and documented in the student’s medication log. For such medication not in capsule or tablet form, standard measuring and monitoring procedures will apply.
2. Designated school staff will follow the written instructions of the physician and parent and training guidelines as may be recommended by the Department of Education for administering all forms of non-injectable medications.
3. Medication will be secured as follows:
a. Non-refrigerated medications will be stored in a locked cabinet, drawer or box used solely for the storage of medication;
b. Medications requiring refrigeration will be stored in a locked box in a refrigerator;
c. Access to medication storage keys will be limited to the building principal and designated school staff.
4. Designated school staff will be responsible for monitoring all medication supplies and for ensuring medication is secure at all times, not left unattended after administering and that the medication container is properly sealed and returned to storage.
5. In the event medication is running low or inadequate dosage is on hand to administer the medication, the designated school staff will notify the parent immediately.
6. Designated school staff will notify 911 or other appropriate emergency medical response systems and administer first aid as necessary in the event of life threatening side effects that result from district administered medication or from student self-medication. The parent, school nurse and building principal will be notified immediately.
7. Minor adverse reactions that result from district administered medication or from student self-medication will be reported to the parent immediately.
Disposal of Medications
Medication not picked up by the parent at the end of the school year or within 5 school days of the end of the medication period, whichever is earlier, will be disposed of by designated school staff in a non-recoverable fashion as follows:
1. Medication in capsule, tablet or liquid form will be removed from their original container (destroy any personal information). Crush solid medications, mix or dissolve in water (this applies to liquid as well) and mix with an undesirable substance such as coffe ground, kitty litter, flour, etc. and place it in impermeable, nondescript containers such as empty cans or sealable bags, placing these containers in the trash. Flush prescriptions down the toilet only if the accompanying patient information specifically instructs it is safe to do so. (ONDCP Federal Government Guidelines, February 20, 2007);
2. Other medication will be disposed of in accordance with established training procedures.
All medications will be disposed of by designated school staff in the presence of another school employee and documented as described below.
Documentation and Record Keeping
A system of logging medications will be maintained for each student administered medication by the district. The system will include but not be limited to:
1. The name, dose and route of medication administered; date and time of administration and name of the person administering the medication;
2. Student refusals of medication;
3. *Errors in administration of medication;
4. *Emergency and minor adverse reaction incidents;
5. Discrepancies in medication supply;
6. Disposal of medication including date, quantity, manner in which the medication was destroyed and the signature of the school staff involved;
*Designated school staff may note incident by symbol in medication log and attach detailed documentation as necessary.
All records relating to administration of medications, including permission slips and written instructions, will be maintained in a separate, medical file apart from the student’s education records unless otherwise related to the student’s education placement and/or individualized education plan. Records will me retained in accordance with applicable provisions of OAR (22), (23) and (24).
Student medical files will be kept confidential. Access shall be limited to those designated school staff authorized to administer medication to students, the student and his/her parents. Information may be shared with school staff with a legitimate educational interest in the student or others as may be authorized by the parent in writing. Some information may be exempt from being disclosed to parents or guardians. The principal or his/her designee will review medication log prior to disclosure to parent or guardian.
A school administrator, teacher or other school employee designated by the school administrator is not liable in a criminal action or for civil damages as a result of the administration of prescription and/or nonprescription medication as per ORS 339.870.
Field Trips
A staff person trained in medication administration shall accompany any group leaving the building when medication administration is required by any students participating in field trips. This requirement may be waived if the student’s parent accompanies the field trip as chaperone.
The trained person assigned to administer the medication must carry medication in its original, labeled container.
Medication must never be left unattended. Staff may carry it on their person, in a fanny pack, or in a secure (locked) container.
Before leaving for the field trip, medication must be signed out by the trained staff person. Upon returning from the field trip, trained staff person must sign the medication in and document that the medication was given.
When medication must be administered during a field trip, teachers must provide at least 3 days notice to the office so that appropriate arrangements can be made.