Emergency Conditions or Medications at School

Emergency Action Plans (EAP) at School

Examples may include: Anaphylactic reactions requiring an epi-pen, Asthma requiring a rescue inhaler, Seizures, Diabetes and etc.

An Emergency Action Plan (EAP) is recommended for students that have medical conditions that can result in emergency situations that require immediate response during the school day.

• • An EAP provides guidance to Department of Education (DOE) personnel involved with the student so that emergency situations can be recognized and responded to as quickly and appropriately as possible. 

  • To request an Emergency Action Plan for your student's medical condition, you may contact the Kalaheo Health Room at 808-305-0243 or stop by the health room or front office during school hours.

  • After notifying the school of your student's Emergency Medical Condition, a Public Health Nurse or Hawaii Keiki Registered Nurse or Advanced Practice Registered Nurse will be in contact with you to provide guidance and next steps.

Request to Store or Administer Daily or Rescue Medications while at School

Examples may include: storing an epi-pen, storing an inhaler, or storing a daily scheduled medication in the health room. Please click the link "SH36 Request to Store and Administer Emergency Rescue Medications and Daily, Routine, Scheduled Medications" to be provided an SH36 Form to fill out and provide to your student's physician.

No medications will be administered by the authorized DOE or DOH personnel without the completion of the SH36 Form, which includes the following requirements:

1. Parent/legal guardian must complete Section I of SH36, "PARENT’S/LEGAL GUARDIAN'S REQUEST, AUTHORIZATION, and WAIVER of LIABILITY";

2. Physician or other practitioner with prescriptive authority must complete Section II of SH36, Physician’s or Other Health Professional's Request;

3. The completed SH36 must be returned to the Kalaheo Health Room for Nurse approval where once completed it will be provided to the Kalaheo School Health Assistant and maintained on file in the school health room.

4. This form is applicable only for the current school year and must be renewed yearly.
   The parent/legal guardian are responsible for submitting requests for the subsequent school year.

In order for medications to be stored and administered in school, the medications must:

1. Be dispensed by a pharmacist in accordance with HRS §328-16 (a)(10);

2. Be in a container/vial labeled “FOR SCHOOL USE;”

3. Include the name of the student, name of the medication, dosage, strength, time of administration, and name of prescribing physician or other practitioner with prescribing authority. The instructions on the container must state, “FOR SCHOOL USE;”

4. Be designated on a completed Form SH36

The parent/legal guardian is responsible for providing an appropriately labeled supply of medications and a recent photo of their child to the health room at school. This should be coordinated with the school health assistant, the child's teacher(s), and the school principal. Medications that are discontinued or unused must be picked up by the parent/legal guardian.

For more information regarding medications for your student at school, please click the link "SH36 Request to Store and Administer Emergency Rescue Medications and Daily, Routine, Scheduled Medications"  or Request for Diabetes Care/Insulin Administration in School below. 

• Authorization for Use or Disclosure PHI

• SH36 - Request to Store and Administer Medications (Revised 1_2024)

• Volunteer Authorization to Administer Epinephrine and Glucagon (Revised 6_2023)

• SH36 DM - Request for Diabetes Care and Medication Administration (Revised 1_2024)

Self-Administration of Medication while at School

Hawaii Revised Statutes §302A-1164 allows for students to carry and self-administer their inhaler, auto injectable epinephrine, and/or insulin and supplies for self-management of their emergency medical condition.

The Self-Administration of Medication form must

1. Be completed by student’s parent(s)/legal guardian(s) 

2. Be completed by the student's medical provider

3. The completed Self-Administration Form will be returned to the Kalaheo School Health Room where it will be:
   
   

   1. Completed self-administration forms are applicable only for the current school year.
      The parent/legal guardian are responsible for submitting requests for the subsequent school year.

For more information regarding Self-Administration of Medication for your student at school, please click the link "Self-Administration Form" below. 

• Student Medication Self-Administration and Carry Authorization (Revised 1_2024)