Policy - JLCD

 POLICY:  JLCD

EFFECTIVE DATE:  12/6/23

REVIEWED BY POLICY COMMITTEE: 10/18/23

ADMINISTERING MEDICATION TO STUDENTS

The RSU #74 School Board acknowledges that in certain instances it may be necessary for a student to have medication administered to him/her while in attendance at school. The RSU #74 School Board discourages the administration of medication on school premises where other options exist. The first dose of a newly-prescribed medication must be given at home.

A.    REQUESTS TO ADMINISTER MEDICATIONS PURSUANT TO HEALTH PROVIDER ORDER

The following procedure must be followed for any prescription or over the counter medication to be administered to a student pursuant to a health care provider’s order. Such an order must be obtained from a medical/health practitioner who has a current license with a scope that includes administering medication. This section does not apply to the administration of medical marijuana; please see Section C or specific requirements.

1. The parent/legal guardian shall obtain a copy of the RSU#74 Request/Permission to Administer Medication in School Form A and Board Policy JLCD from the school nurse or school office.

2. The parent/legal guardian and the student’s health care provider shall complete and sign the Request/Permission (Form A).

3. The parent/legal guardian shall return the Request/Permission Form A to the (school office or school nurse) along with the medication (RSU#74 Will NOT provide any medications).

·         In the original container (and in the case of prescription medications, appropriately labeled by the health care provider or pharmacy);

·         Including no more than the amount of medication necessary to comply with the health provider’s order.

4. The school nurse shall review the Request/Permission Form A for completeness and clarity. If the nurse has any questions or concerns about the form, he/she will contact the parent/legal guardian and/or health care provider, as appropriate, for more information.

5. If there is a later change in the medical order (such as change in dose, frequency or type of medication), a new Request/Permission form must be completed.

6. Medication orders must be renewed at least annually.

7. Medication no longer required (or remaining at the end of the school year) must be removed by the parent/legal guardian. Medication not removed by the parent/legal guardian in a timely manner shall be disposed of by the school unit.

8. The RSU #74 School Board disclaims any and all responsibility for the diagnosis, prescription of treatment, and administration of medication for any student.

SELF-ADMINISTRATION OF MEDICATIONS

Self-Administration means that the student is able to consume or use the medication safely and in a manner directed by the licensed prescriber without additional assistance or direction.

In general, self-administration of all medications in school is prohibited and students are not allowed to carry medications in school.

An exception shall be made for students diagnosed with Asthma or needing epi-pens as     determined by a physician. Students may self-administer prescribed inhalers and epi-pens. The school nurse shall determine the student’s ability to self-administer before allowing the student to carry the medication on his/her person (See Request/Permission Form A).

An additional exception to the above policy may be if it is determined by the school nurse, the student’s parents/legal guardian, and the student’s physician that the student is capable of self-administration such medications as insulin, enzymes or lactose intolerant treatments, and that it is in the best interest of student to do so. Some medications may require an additional form to be completed by the medical provider. The building principal shall be informed of any such exception.

Sunscreen

Students are allowed to possess and use a topical sunscreen product while on school property or at a school-sponsored event without a note or prescription from a licensed health care professional if the product is regulated by the Federal Food and Drug Administration (FDA) for over-the counter use for the purpose of limiting skin damage from ultraviolet radiation.

B.     PROCEDURE FOR MEDICATION ADMINISTRATION ON SCHOOL FIELD TRIPS/OFF-CAMPUS EVENTS

Training

Any unlicensed personnel administering medications, both prescription and over the counter, must hold documentation of their training in the administration of medication, including personnel administering medication on a field trip or other off campus school-sponsored event.  

Training for administering medication for a field trip only may be an abbreviated version of the Training of Nonlicensed School Personnel in Medication Administration but is only valid for that specific field trip/event.  

Orders/Permissions

There must be written permission from the parent/guardian providing consent to administer the medication in school and a written physicians order and/or an appropriately labeled original medication container as required in Chapter 40, Rule for Medication Administration in Maine Schools.

Labeling/Packaging

Either a standardized preprinted medication label, preprinted envelope containing the information described below, or medication in its original container will be used for students attending a field trip. 

• Date

• Student name

• Medication name

• Dose and time to be given

• Physician name

• School Nurse contact information

 • Emergency number  

When using a preprinted label or preprinted envelope, the school nurse shall transfer the prescribed amount of medication needed for the field trip from the original medication container into the approved envelope and fill in the appropriate information on the envelope.

The envelope will be provided to the trained personnel for administration during the trip. The school nurse will provide a review of the medication and its administration to the trained personnel on an as needed basis. All trained personnel administering medication must understand what to do in an emergency. 

Transportation/Storage

The medication will be transported and stored in compliance with any special directions for the medication and will be secured as safely as possible.   

Administration

The administration of medication on a field trip will duplicate as much as possible, the guidelines found in the Medication Administration Handbook for Unlicensed School Personnel. This will include consideration of student privacy and cleanliness of area where medications are administered. 

Medication will be administered to the student to assure that the right student receives the right medication, with the right dose, at the right time, by the right route. The trained personnel administering the medication will double check the student with the medication label and will double check the dose. The medication will be administered within 30 minutes either side of the prescribed time. 

Overnight/ Out of the State/ Out of the Country Field Trips (See Form B)

Medical forms must be completed and returned two weeks’ prior in order to plan for the health needs of all students. If the necessary timeline is not met, the student may not participate in the field trip.

In addition to the medical forms, all prescription and necessary over the counter medications your student requires during the trip must be brought to the school nurse to allow for adequate time to assemble information and share it with staff chaperones.

Prescription medications must be brought in a labeled prescription bottle (an additional labeled bottle can be obtained from your pharmacy for you to bring these pills in).

Students will not be allowed to go on the trip if the medical information and medications are not received prior to departure. Please contact the school nurse for any concerns not addressed on the form.

No medication may be given by the teacher in charge unless the nurse has checked in the medication first.

C. ADMINISTRATION OF MEDICAL MARIJUANA

The Maine Medical Use of Marijuana Act governs the administration of medical marijuana in schools in Maine. The Department of Administration and Financial Services (“DAFS”) is the regulatory agency charged with implementing the Maine Medical Use of Marijuana Act. The Maine Medical Use of Marijuana Program, located within DAFS, is charged with the administrative duties associated with implementation, such as the issuance of registration cards.

The following procedure must be followed for the administration of medical marijuana to students at school.

1. The student’s parent/legal guardian/legal custodian shall obtain a copy of the RSU#74 Request/Permission to Administer Medical Marijuana in School Form C and School Board Policy JLCD from the school nurse or school office.

2. The parent/legal guardian/legal custodian and the student’s authorized medical provider (physician,

certified nurse practitioner or physician assistant) shall complete and sign the request/Permission

Form, and attach a copy of the student’s current written certification for the use of medical marijuana. The original certification must be shown to the school employee processing the request. A copy will be retained by the school.

3. The parent/legal/guardian/legal custodian must designate the caregiver who will administer medical marijuana to the student in school (including for students over the age of 18). The designated caregiver must be registered with the Maine Medical Marijuana Program. The original registry identification card and caregiver designation form must be shown to the school employee processing the request. Copies will be retained by the school.

4. If the designated caregiver is not a parent/legal guardian/legal custodian of the student, the designated caregiver must also submit verification that he/she is authorized by the State to administer marijuana to the student on school grounds.

5. Arrangements will be made between the school administration and the designated caregiver to schedule the administration of medical marijuana in a manner that will minimize disruption to school operations and the student’s educational program, and that will not impact other students or employees. The designated caregiver must comply with all Board policies and school rules while on school premises to administer medical marijuana to a student.

6. Medical marijuana must be brought to school by the caregiver, and may not be held, possessed or administered by anyone other than the caregiver. The student may only possess the medical marijuana during the actual administration process. Medical marijuana administered in school must be in a nonsmokeable form (vaporizers are not permitted).

7. The designated caregiver must check-in at the school office upon arrival for the administration of medical marijuana. Medical marijuana may only be administered in the following locations [school office, nurse’s office – as determined by administration].

8. The designated caregiver must check-out at the school office following administration of the medical marijuana and transport any remaining medical marijuana with him/her off school premises.

    D. Personnel Authorized to Administer/Dispense Medications

Medications (other than medical marijuana) may be administered by the school nurse and/or by authorized unlicensed school personnel who have received appropriate training from a registered professional nurse or physician. Annual refresher training is required for all unlicensed personnel authorized to administer medications. 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.

     E. Administration of Epi-Pens to Students Without a Prescription

RSU #74 has “collaborative practice agreement” which allows the administration of an epi-pen to a student who does not have a prescription in an emergency when the student is experiencing anaphylaxis during school or a school-sponsored activity. The epi-pen must be administered by the school nurse or other authorized unlicensed personnel who had received the training required by this policy and the collaborative practice agreement.

     F. Stocking, Possession and Use of Naloxone Hydrochloride

RSU #74 has entered into a collaborative practice agreement whereby the school health advisor (or other physician licensed in Maine) had prescribed Naloxone hydrochloride and directed that the school nurse to administer naloxone hydrochloride to a student, staff member or visitor experiencing an apparent opioid overdose during school, during a school-sponsored activity or on school grounds. [IF PART OF THE AGREEMENT: The School nurse has designated other trained school employees to administer naloxone hydrochloride when the nurse is not present]

911 will be called when naloxone hydrochloride is being administered.

     G. Confidentiality of Information

RSU #74 School Board policies and practices for medication administration must ensure that student confidentiality is protected, as outlined in the Family Education Rights and Privacy Act and the Health Insurance Portability and Accountability Act. To the extent legally permissible, school staff may be provided with such information regarding a student’s medication(s) as may be in the best interest of the student.

    H. Storage of Medications/Recordkeeping/Annual Report

1. All medications shall be stored in a secure space in the school nurse’s office or school office and locked at all times except during the actual administration of medication.

2. Clearly marked containers are provided to store all daily medications and those to be taken as needed.

3. A Medication Record Book either electronically or on paper shall be maintained by the school nurse/ULAP designee, including the Request/Permission Forms and individual medication records for each student to document the administration of all medications (dose administered, by whom, date, time and any errors).

4. The school units (school nurse) shall provide an annual report to the Maine Department of Education summarizing and analyzing incidents involving a severe allergic reaction or administration of an epinephrine auto-injector.

      I. Administrative Procedures

The RSU #74 Superintendent/designee shall develop any administrative procedures necessary to implement this policy and as required by the Maine Department of Education Rules.

Legal Reference:

20-A MRSA §§ 254(5); 4009(4); 6305; 6306

22 MRSA §§ 2423-A; 2425-A; 2426;

Maine Public Law, Ch. 452 (2018) Maine Department of Education Rule Chapter 40

28 CFR Part 35 (Americans with Disabilities Act of 1990)

34 CFR Part 104 (Section 504 of the Rehabilitation Act of 1973) 34 CFR Part 300 (Individuals with Disabilities Education Act)

                                 20-A MRSA §254 (1), sub-§5