JLCD Medication Policy

The Board discourages the administration of medication to students during the school day when other options exist, but recognizes that in some instances it may be necessary for a student to have medication administered to him/her while the student is in attendance at school. It is not the intent of the school to deny educational opportunities to students requiring the administration of medication in order to remain in attendance and participate in the educational program.

The intent of this policy is to promote the safe administration of medications to students by school personnel and to provide for authorization of student emergency self-administration of medication from asthma inhalers and epinephrine auto injectors. This policy does not apply to the administration of medical marijuana; please see JLCDA-Medical Marijuana in Schools policy for specific requirements.

The Board encourages collaboration between parents/guardians and the schools in matters involving student medication.

The Board disclaims any and all responsibility for the diagnosis, prescription of treatment, and administration of medication for any student, and for any injury arising from a student's self-administration of medication.

I. DEFINITIONS

"Administration" means the provision of prescribed medication to a student according to the orders of a healthcare provider. "Health care provider" means a medical/health practitioner who has a current license in the State of Maine with a scope of practice that includes prescribing medication. "Indirect supervision" means the supervision of an unlicensed school staff member when the school nurse or other health care provider is not physically available on site but immediately available by telephone. "Medication" means prescribed drugs and medical devices that are controlled by the U.S. Food and Drug Administration and are ordered by a healthcare provider. It includes over-the-counter medications prescribed through a standing order by the school physician or prescribed by the student's health care provider. For the purpose of this policy, "medication" does not include medical marijuana. "Parent" means a natural or adoptive parent, a guardian, or a person acting as a parent of a child with legal responsibility for the child's welfare. "School nurse" means a registered professional nurse with Maine Department of Education certification for school nursing. "Self-administration" is when the student administers medication independently to him/herself under indirect supervision of the school nurse. "Unlicensed school personnel" are persons who do not have a professional license that allows them, within the scope of that license, to administer medication.

II. ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNEL

A. Parental Request

In the event that no reasonable alternative exists, the parent/guardian may request in writing that medication be administered to the student during the school day. The first dose of a newly-prescribed medication must be given at home. The written request must include an acknowledgement and agreement that unlicensed personnel may administer the medication as per the health care provider's instructions. In addition, the request shall indicate that information regarding the student's medication may be shared with appropriate school personnel. Parents/guardians may provide the reason (diagnosis) requiring the administration of medication.

Requests shall be valid for the current school year only.

B. Health Care Provider's Order

All parental requests must be accompanied by a written order from the student's health care provider substantiating the fact that the administration of a particular medication during the school day is necessary for the student's health and attendance in school. Such order must include:

1. The student's name;

2. The name of the medication;

3. The dose;

4. The route of administration;

5. Time intervals for administration; [ ]

6. Any special instructions; and

7. The name of the prescribing health care provider.

It is the responsibility of the school nurse to clarify any medication order that he/she believes to be inappropriate or ambiguous. In accordance with Department of Education Rule Chapter 40 § 2(B), the school nurse may decline to administer a medication if he/she believes such administration would jeopardize student safety. In this case, the school nurse must notify the parent/guardian, the student's health care provider and the school administrator (i.e., building principal or designated administrator).

C. Renewal of Parent Permission Requests/Forms and Health Care Provider Orders

Written parental permission requests/forms and health care provider orders must be renewed at least annually. Health care provider orders must be renewed whenever there are changes in the order.

D. Delivery and Storage of Medication

The parent/guardian must supply all medications in the original container and properly labeled along with any administration equipment needed by a student in school, including, but not limited to, glucose tablets, glucagon, epinephrine auto injector, and nebulizer equipment. The parent/guardian shall transport all medications to school unless other arrangements have been made with the school nurse.

The parent/guardian is responsible for notifying the school of any changes in or discontinuation of a prescribed medication that is being administered to the student at school. Medication not removed by the parent/guardian by the end of the school year shall be disposed of by the school nurse.

The school nurse shall be responsible for developing and implementing procedures for the appropriate and secure storage of medications kept at school, and all medications shall be stored in accordance with this procedure.

E. Recordkeeping

School personnel and the student's parent/guardian shall account for all medication brought to school. The number of capsules, pills or tablets, and/or the volume of other medications brought to school shall be recorded.

School staff administering medication shall document each instance the medication is administered including the date, time, and dosage given.

The school nurse shall maintain a record including the parent/guardian's request, physician's order, details of the specific medications, and documentation of each instance the medication is administered.

Records shall be retained according to the current State schedules pertaining to student health records.

F. Confidentiality

To the extent legally permissible, staff members may be provided with such information regarding medication and its administration as may be in the best interest of the student.

School personnel administering medications will maintain student confidentiality.

G. Administration of Medication

Medication may be administered during the school day by licensed medical personnel acting within the scope of their licenses.

The school nurse, under the administrative supervision of the Superintendent, will provide direction and oversight for the administration of medication to students.

All unlicensed personnel who administer medication must receive training before being authorized to do so. The school nurse shall maintain appropriate documentation of training. Authorization to administer medications shall be made by the Superintendent based upon the recommendations of the school nurse.

H. Administration of Medication During Off-Campus Field Trips and School-Sponsored Events

The school will accommodate students requiring administration of medication during field trips or school-sponsored events as follows:

The school nurse, principal, and, as appropriate, the school unit's Section 504 Coordinator and/or IEP, will determine whether an individual student's participation is contraindicated due to the unstable/fragile nature of his/her health condition, the distance from emergency care that may be required, and/or other extraordinary circumstances. If needed, the student's parent/guardian and primary care provider will be consulted in making this determination. The decision will be made in compliance with applicable laws, including the IDEA, § 504 and the Americans with Disabilities Act (ADA).

The parent/guardian must provide the appropriate number of doses needed for the duration of the field trip or school-sponsored event.

When there are no contraindications to student participation, an appropriately trained staff member will be assigned to administer medication. The parent/guardian will be encouraged to accompany the student, if possible, to care for the student and administer medication.

All provisions of this policy shall apply to medications to be administered during off-campus field trips and school-sponsored events. As practicable, the DOE's "Procedure for Medication Administration on School Field Trips" will be followed.

I. Student Self-Administration of Medications

Students may be permitted to possess and self-administer prescription medications in school on a case-by-case basis. All requests must be approved by the school nurse, in consultation with the building principal, who has the discretion to authorize self-medication based on the nature of the medications, the risk of abuse or transfer to other students, the capacity of the student to safely handle the medication and any other relevant factors.

[Epinephrine Auto Injectors and Asthma Inhalers]

The student shall be authorized to possess and self-administer medication from an epinephrine auto injector or asthma inhaler if the following conditions have been met.

1. The student must have the prior written approval of his/her primary health care provider and, if the student is under the age of 18, the prior written approval of his/her parent/guardian. The written notice from the student's primary care provider must specify the name and dosage of the medication, frequency with which it may be administered, and the circumstances that may warrant its use.

2. The student's parent/guardian must submit written verification to the school from the student's primary care provider confirming that the student has the knowledge and the skills to safely possess and use an epinephrine auto injector or asthma inhaler.

3. The school nurse shall evaluate the student's technique to ensure proper and effective use of an epinephrine auto injector or asthma inhaler taking into account the maturity and capability of the student and the circumstances under which the student will or may have to self-administer the medication.

4. The parent/guardian will be informed that the school cannot accurately monitor the frequency and appropriateness of use when the student self-administers medication, and that the school unit will not be responsible for any injury arising from the student's self-medication.

[Diabetic Supplies and Medications]

The parent/guardian will provide a completed diabetes management plan annually if students are treated for diabetes. The parent/guardians are required to provide glucose testing equipment, insulin, glucagon, snacks and other necessary supplies for the student.

Authorization granted to a student to possess and self-administer medication shall be valid for the current school year only and must be renewed annually.

A student's authorization to possess and self-administer medication may be limited or revoked by the building principal after consultation with the school nurse and the student's parents/guardians if the student demonstrates inability to responsibly possess and self-administer such medication.

To the extent legally permissible, staff members may be provided with such information regarding the student's medication and the student's self- administration as may be in the best interest of the student.

Sharing, borrowing, or distribution of medication is prohibited. The student's authorization to self-administer medication may be revoked and the student may be subject to disciplinary consequences for violation of this policy. J. Dispensation of Over-the-Counter Medications With prior written parent/guardian permission, students may receive certain over the counter medications at school, pursuant to a standing order from the school physician/school health advisor. K. Required Training of Unlicensed Personnel to Administer Medication Unlicensed school personnel who administer medication to students in a school setting must be trained in the administration of medication before being authorized to carry out this responsibility. Such training must be provided by a registered professional nurse or physician and include the components specified in Department of Education Rules Chapter 40 and other applicable Department of Education standards, recommendations, programs, and/or methodologies. The trainer shall document the training and competency of unlicensed school personnel to administer medication. Based upon a review of the documentation of training and competency in the administration of medication, the school nurse will make recommendations to the Superintendent/designee pertaining to authorization of such unlicensed personnel pertaining to authorization to administer medication. Following the initial training, a training review and information update must be held at least annually for those unlicensed school personnel authorized to administer medication.

L. Delegation and Implementation The Superintendent/designee shall be responsible for developing administrative procedures and/or protocols to implement or supplement this policy. Such procedures/protocols shall include direction regarding:

1. Safe transport of medication to and from school;

2. Administration of medication during field trips and school-sponsored events;

3. Accountability for medications, particularly those regulated by Schedule II

of the Controlled Substances Act;

4. Proper storage of medication at school;

a. Training of appropriate staff on administration of emergency medications including the standards for the signs and symptoms of anaphylaxis and the use of epinephrine auto injectors for previously unknown severe allergies;

5. The procedure to follow in the event of a medication reaction;

6. Access to medications in case of a disaster;

7. The process for documenting medications given and medication errors;

and

8. The proper disposal of medications not retrieved by parents/guardians.

Legal Reference: 20-A M.R.S.A. §§ 254(5); 4009(4); 4502 (5)(N); 6305

Me. Dept. of Ed. Rule Ch. 40 (2016)

21 USC §801 et. seq. (Controlled Substances Act)

28 C.F.R. Part 35 (Americans with Disabilities Act of 1990)

34 C.F.R. Part 104 (Section 504 of the Rehabilitation Act of 1973)

34 C.F.R. Part 300 (Individuals with Disabilities Education Act)

Cross Reference: JLCD-E -- Medication Administration on School Field Trips (Me. DOE)

JLCDA -- Medical Marijuana in Schools

Adopted: March 27, 2017

Revised: March 26, 2018