NEPN/NSBA Code:  JLCD 

ADMINISTERING MEDICINES TO STUDENTS 

The purpose of this policy is to provide a safe procedure for the administration of medications to students in the Lewiston Public Schools and to provide for authorization of student emergency self-administration of medication from asthma inhalers and epinephrine auto-injectors. The policy provides guidelines based on the limitations of the availability of health professionals within the school district. 

This policy is not to be considered a replacement of parental responsibility for the administration of medication in the schools. The administration of medication in the schools should only occur when it is absolutely necessary that medication be administered while school is in session. It is the ultimate responsibility of the parents to provide for administration of medication for their children. 

The Committee 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. 

Lewiston Pubic Schools look forward to the cooperation of health professionals in the community to assist those who will be undertaking this responsibility. 

Definitions 

“Administration” means the provision of prescribed medication to a student according to the orders of a health care provider. 

“Collaborative practice agreement” means a written and signed agreement between a physician licensed in Maine or a school health advisor, as defined in 20- A MRSA §6402-A, and a school nurse that provides for the prescription of epinephrine autoinjectors by the physician or school health advisor and administration of epinephrine injectors by the school nurse or designated school personnel to students during school or a school-sponsored activity under emergency circumstances involving anaphylaxis. 

“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 health care 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. 

Administration of Medications 

A.  The procedure/protocols for medication administration were developed by: 

1. School Committee; 

2. School Administrators; 

3. School Medical Advisor; and 

4. School Nurses. 

B.  The policies and procedures regarding medication administration will be reviewed and updated biannually by: 

1.  School Committee; 

2. School Administrators; 

3. School Medical Advisor; and 

4. School Nurses. 

C.  The School Committee will provide copies of revised and updated policies to all personnel involved in the administration of medication to students. 

Procedures for Delivery and Storage of Medication 

A.   The student’s parents shall deliver any medication to be administered by school personnel to the school in its original container and properly labelled. In the event that this is not practical, the parent must contact the school to make alternate arrangements. Medication must be accompanied by a signed authorization form. 

When possible, no more than a 20-day (one month) supply of medication shall be kept at school, excluding inhalers and epinephrine autoinjectors. The parent is responsible for the replenishment of medication kept at school. 

The parent 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 and provide documentation from the medical provider ordering such changes. The parent must remove any medication no longer required or that remains at the end of the school year. 

B. Medication will be stored: 

1.  In a box/cabinet used solely for the storage of medication. 

2.  Refrigerated medication will be stored separately in a box in the refrigerator at 36-46 degrees Fahrenheit. 

3.   Controlled drugs will be kept in a double-locked system. 

4.  The school nurse, or in his/her absence, building administrators or designated personnel will have access to the medication keys. 

5.  Unused medication will be destroyed or returned to parent/guardian as directed on “Authorization to Administer Medication” form. 

Documentation and Record Keeping 

A.   Medication orders will be obtained in writing from prescribing physician/dentist and/or written authorization from the parent/guardian. 

B.  The administration of medication will be documented on an individual student’s medication record in ink and will become part of the student’s health record. 

C.   An error in the administration of medication will be reported to the school nurse, the parent, and the student’s physician who will initiate appropriate action. 

D.  The Medication Incident Report Form is to be used for reporting medication errors. 

E.  It is medically acceptable to give a medication within one hour (before or after) of designated time. 

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. 

Training School Personnel 

No employee shall be required to administer or dispense any medication to a student or perform any medical procedure upon a student without proper training by the school nurse. 

A.  The school nurse will provide a training program. 

B.  Training will be provided annually before October 1. 

C.  Documentation of training will be kept using the “Record of Training of School Personnel in the Administration of Medicines.” Copies will be kept by the Superintendent’s office, by building administrators, and by school nurses. 

D.  Administrators, in collaboration with the nurses, will designate personnel for training. The intent is to utilize qualified staff who have volunteered for training. However, should extenuating circumstances arise, the administration reserves the right to designate responsible staff to be trained. 

E.  Once properly trained, Lewiston Public Schools indemnifies and holds harmless the employee against any claims resulting from the administration of medication or performance of medical procedures that have met the criteria as set forth in this policy. 

Dispensation of Over-the-Counter Medications 

With prior written parent permission, students may receive certain over the counter medications at school pursuant to a standing order from the school physician/school health advisor. 

Hypodermic Syringes in a School Setting 

Certain safeguards must be followed relative to the storage and destruction of syringes. 

A.  Unused hypodermic syringes and needles should be kept locked in a cabinet or in rooms under protection of suitable locks and keys. 

B.  Used needles and lancets will be disposed of in a hard plastic container. 

C.  The school nurse will be responsible for the proper storage and disposal of this container. 

D.  An emergency care for such students should be in place in case the school nurse is not available. 

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

Self-Administration of Medications 

Self-administration of medications (including inhalers & Epi-pens) will be allowed if these conditions are met: 

1)  Medication will be properly packaged with original pharmacy labels.

2)  A signed medication authorization form signed by physician/dentist and/or parent/guardian. 

3) The school nurse will develop individual plan with the student for use of this medication taking into consideration age,development, understanding, and reliability. 

4)  Inhalers may be kept by a student: 

K-6 – As directed by a physician if the school nurse has determined that the student uses the inhaler properly. 

7-12 – in agreement with a parent/guardian if the school nurse has determined that the student uses the inhaler properly. 

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. 

Lewiston Public Schools reserves the right to refuse requests for administering medication to students if any of the criteria outlined above are not met. 

Legal Reference: 20-A MRSA § 254 and 4009(4) ); 4502 (5)(N); 6305 Me. Dept. of Ed. Rule Ch. 40 (2016) 

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

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) 

Cross Reference: JLCD-E – Medication Administration on School Field Trips JLCD-E1 – Authorization to Administer Medication 

JLCD-E2 – Medication Policy 

JLCD-E3 – Record of Training of School Personnel in the Administration of Medicines 

JLCD-E4 – Incident Report-Medication Administration 

Adopted: July 17, 1995 

Revised: June 7, 2000 

Reviewed: September 24, 2012 

Revised: July 17, 2017 

Revised: September 24, 2018