1. Medication shall not be administered to any student without a completed Medication Order from a physician or dentist licensed to practice medicine in Louisiana or an adjacent state, or any other authorized prescriber authorized in the state of Louisiana to prescribe medication or devices, and a letter of request and authorization from the student's parent or guardian.  The following information shall be included:

1. the student's name

2. the name and signature of the physician/dentist/other authorized prescriber

3. physician's/dentist's/other authorized prescriber's business address, office phone number, and emergency phone numbers

4. relevant diagnosis

5. name, amount of each school dose, time of school administration, route of medication, and reason for use of medication

6. a written statement of the desired effects and the child specific potential adverse effects

2. Medication shall be provided to the school by the parent/legal guardian in the container that meets acceptable pharmaceutical standards and shall include the following information:

1. name of pharmacy

2. address and telephone number of pharmacy

3. prescription number

4. date dispensed

5. name of student

6. clear directions for use, including the route, frequency, and other as indicated

7. drug name and strength

8. last name and initial of pharmacist

9. cautionary auxiliary labels, if applicable

10. physician's/dentist's/other authorized prescriber's name

Labels of prepackaged medications, when dispensed, shall contain the following information in addition to the regular pharmacy label:

1. drug name

2. dosage form

3. strength

4. quantity

5. name of manufacturer and/or distributor

6. manufacturer's lot or batch number

1. Once trained, the school employee who administers medication may not decline to perform such service at the time indicated, unless exempted in writing by the MD or RN.
   
   

2. During the period when the medication is administered the person administering medication must be relieved of all other duties.  This requirement does not include the observation period required in 2.-F below.
   
   

3. Except in the case of a trained unlicensed diabetes care assistant administering diabetes medications (if applicable) or in life-threatening situations, trained unlicensed school personnel may not administer injectable medications.
   
   

4. All medications must be stored in a secured locked area or locked drawer with limited access except by authorized trained school personnel.
   
   

5. Only oral, inhalant, topical ointment for diaper rash, and emergency medications may be administered at school by unlicensed, but trained, school personnel.  Under special circumstances, other medications not mentioned above may be administered as necessary, as approved by the school nurse.
   
   

6. Each student must be observed by a school employee for a period of 45 minutes following the administration of medication.  This observation may occur during instruction time.
   
   

7. School medication orders shall be limited to medication which cannot be administered before or after school hours.

1. The school nurse, in collaboration with the principal, shall supervise the implementation of the school policies for the administration of medications in schools to ensure the safety, health and welfare of the students.
   
   

2. The school nurse shall be responsible for the training of non-medical personnel who have been designated by each principal to administer medications in each school.  The training must be at least six (6) hours and include but not be limited to the following provisions:

1. Proper procedures for administration of medications including controlled substances

2. Storage and disposal of medications

3. Appropriate and correct record keeping

4. Appropriate actions when unusual circumstances or medication reactions occur

5. Appropriate use or resources

1. The parent/legal guardian who wishes medication administered to his/her child shall provide the following:

1. A letter of request and authorization that contains the following information:

1. the student's name;

2. clear instructions for school administration;

3. prescription number, if any;

4. current date;

5. relevant diagnosis;

6. name, amount of each school dose, time of school administration, route of medication, and reason for use of medication;

7. physician's/dentist's/other authorized prescriber's name;

8. the parent's/legal guardian's printed name and signature;

9. parent's/legal guardian's emergency phone number;

10. statement granting or withholding release of medical information;

2. A written order for each medication to be given at school, including annual renewals at the beginning of the school year.  The new orders dated before July of that school year shall not be accepted.  No corrections shall be accepted on the physician's Medication Order form.  Alteration of this form in any way or falsification of the signature is grounds for prosecution.  Orders for multiple medications on the same form, an incomplete form, or a form with a physician's/dentist's/ other authorized prescriber's stamp shall not be accepted.  Faxed orders may be accepted; original orders must be received within five (5) business days.
   
   

3. A prescription for all medications to be administered at school, including medications that might ordinarily be available over-the-counter.  Only the physician/dentist/other authorized prescriber or his/her staff may write on the Medication Order form.  This form must be signed by the physician/dentist/other authorized prescriber.
   
   

4. A list of all medications that the student is currently receiving at home and school, if that listing is not a violation of confidentiality or contrary to the request of the parent/legal guardian or student.
   
   

5. A list of names and telephone numbers of persons to be notified in case of medication emergency in addition to the parent/legal guardian and licensed physician/dentist/other authorized prescriber.
   
   

6. Arrangements for the safe delivery of the medication to and from school in the properly labeled container as dispensed by the pharmacist; the medication must be delivered by a responsible adult.  The parent/ legal guardian will need to get two (2) containers for each prescription from the pharmacist in order that the parent/legal guardian, as well as the school, will have a properly labeled container.  If the medication is not properly labeled and does not match the physician's order exactly, it will not be given.

2. All aerosol medications shall be delivered to the school in pre-measured dosage.
   
   

3. Provide no more than a thirty-five (35) school day supply of medication in a properly labeled container to be kept at school.
   
   

4. The initial dose of a medication shall be administered by the student's parent/legal guardian outside the school jurisdiction with sufficient time for observation for adverse reactions.
   
   

5. The parent/legal guardian shall work with those personnel designated to administer medication as follows:

1. Cooperate in counting the medication with the designated school personnel who receives it and sign the Drug Receipt form.
   
   

2. Cooperate with school staff to provide for safe, appropriate administration of medications to students, such as positioning, and suggestions for liquids or foods to be given with the medication.
   
   

3. Assist in the development of the emergency plan for each student.
   
   

4. Comply with written and verbal communication regarding school policies.
   
   

5. Grant permission for school nurse/physician/ dentist/other authorized prescriber consultation.
   
   

6. Remove or give permission to destroy unused, contaminated, discontinued, or out-of-date medications according to the school guidelines.

1. Written authorization for the student to carry and self-administer such prescribed medications.
   
   

2. Written certification from a licensed medical physician or other authorized prescriber that the student:

1. has asthma, diabetes, or is at risk of having anaphylaxis
   
   

2. has received instruction in the proper method of self-administration of the student’s prescribed medications to treat asthma, diabetes, or anaphylaxis

3. A written treatment plan from the student’s licensed physician or authorized prescriber for managing asthma, diabetes, or anaphylactic episodes.  The treatment plan shall be signed by the student, the student’s parent or other legal guardian, and the student’s physician or other authorized prescriber.  The treatment plan shall contain the following information:

1. The name, purpose, and prescribed dosage of the medications to be self-administered.
   
   

2. The time or times the medications are to be regularly administered and under what additional special circumstances the medications are to be administered.
   
   

3. The length of time for which the medications are prescribed.

4. Any other documentation required by the School Board.

The required documentation shall be maintained in the office of the school nurse or other designated school official.

 

The School Board shall inform the parent or other legal guardian of the student in writing that the school and its employees shall incur no liability as a result of any injury sustained by the student from the self-administration of medications used to treat asthma, diabetes, or anaphylaxis.  The parent or other legal guardian of the student shall sign a statement acknowledging that the school shall incur no liability and that the parent or other legal guardian shall indemnify and hold harmless the school and its employees against any claims that may arise relating to the self-administration of medications used to treat asthma, diabetes, or anaphylaxis.

 

A student who has been granted permission to self-administer medication by the School Board shall be allowed to carry and store with the school nurse or other designated school official an inhaler, auto-injectable epinephrine, or insulin, at all times.

 

Permission for the self-administration of asthma or diabetes medications or use of auto-injectable epinephrine by a student shall be effective only for the school year in which permission is granted.  Permission for self-administration of asthma or diabetes medications or the use of auto-injectable epinephrine by a student shall be granted by the School Board each subsequent school year, provided all of the requirements of this part of the policy are fulfilled.

 

Upon obtaining permission to self-administer asthma or diabetes medication or to use auto-injectable epinephrine, a student shall be permitted to possess and self-administer such prescribed medication at any time while on school property or while attending a school sponsored activity.  A student who uses any medication permitted by this policy in a manner other than as prescribed shall be subject to disciplinary action; however, such disciplinary action shall not limit or restrict such student’s immediate access to such prescribed medication.

 

Auto-injectable epinephrine means a medical device for the immediate self-administration of epinephrine by a person at risk for anaphylaxis.

 

Glucagon means a hormone that raises the level of glucose in the blood.  Glucagon, given by injection is used to treat severe hypoglycemia.

 

Inhaler means a medical device that delivers a metered dose of medication to alleviate the symptoms of asthma.

 

Insulin Pen means a pen-like device used to put insulin into the body.

 

Insulin Pump means a computerized device that is programmed to deliver small, steady, doses of insulin.

 

Other Permitted Medications

 

Self-administration of other medications by a student may be permitted by the School Board, provided that:

1. Medication Order from the physician or authorized prescriber and from the student's parent or guardian shall be on file and communication with the prescriber has been established.
   
   

2. The school nurse has evaluated the situation and deemed it to be safe and appropriate, and has developed a medical administration plan for general supervision.  The administration plan may include observation of the procedure, student health counseling and health instruction regarding the principles of self-care.
   
   

3. The principal and appropriate staff are informed that the student is self-administering the prescribed medication.
   
   

4. The medication is handled in a safe, appropriate manner.
   
   

5. The school principal and the school employed registered nurse determine a safe place for storing the medication.
   
   The medication must be accessible if the student's health needs require it; this information is included in the medication administration plan.
   
   

6. Some medication should have a backup supply readily available.
   
   

7. The student records the medication administration and reports unusual circumstances (as a general rule the student must record all dates and times he/she is self-medicating during school hours.  The medication log shall be kept in the main office where the student shall record this information unless otherwise noted on the student's Individual Administration Plan).
   
   

8. The school employed registered nurse, and/or the designated employee monitors the student.

1. Medication to modify behavior (e.g., Ritalin, when the sustained action form of this medication is not effective.)
   
   

2. Severe allergic reactions - must have specific written instructions from a physician.
   
   

3. Anticonvulsive medication.
   
   

4. Medication for asthma or diabetes.
   
   

5. Medication given in extenuating circumstances.
   
   

6. Non-prescription (over-the-counter) drugs will only be given if medical certification of extenuating circumstances and prescription is obtained.
   
   

7. Antibiotics and other short-term medications will not be given at school, unless so ordered by a physician, dentist, or authorized prescriber.
   
   

8. The school nurse or trained school employee shall have the authority to administer auto-injectable epinephrine, as defined elsewhere in this policy, to a student who the school nurse or trained school employee believes is having an anaphylactic reaction, whether or not the student has a prescription for epinephrine.  At least one employee at each school shall receive training from a registered nurse or licensed medical physician in the administration of epinephrine.
   
   

9. Other specific illnesses that require medication.

1. A detailed evaluation of the student’s level of understanding of his/her condition and his/her ability to manage his/her diabetes.
   
   

2. The diabetes-related healthcare services the student may receive or self-administer at school or during a school-related activity.
   
   

3. A timetable, including dosage instructions, of any diabetes medications to be administered to the student or self-administered by the student.
   
   

4. The signature of the student (if age appropriate), the student’s parent or legal guardian, and the physician or other authorized health care prescriber responsible for the student’s diabetes treatment.

The parent or legal guardian of a student with diabetes shall annually submit a copy of the student’s diabetes management and treatment plan to the principal or appropriately designated school personnel of the school where the student is enrolled.  The plan shall be reviewed by appropriate school personnel either prior to or within five (5) days after the beginning of each school year, or upon enrollment if the student enrolls after the beginning of the school year or as soon as practicable following the student being diagnosed with diabetes, or as warranted by changes in the student’s medical condition.

 

Upon receipt of the student’s diabetes management and treatment plan, the school nurse shall conduct a nursing assessment of the student’s condition and develop an Individualized Healthcare Plan (IHP).  The school nurse shall be given not less than five (5) school days to develop the IHP and shall implement the IHP within ten (10) school days of receipt of the diabetes treatment plan.  The school nurse must assess the stability of the student’s diabetes both at home and in the school setting prior to the development of the IHP for care in the school setting.

 

The parent or legal guardian shall be responsible for all care related to the student’s diabetes management and treatment plan until the IHP is developed, the parents or legal guardian have agreed to and signed the IHP, and the diabetes management and treatment plan is put into place by the school nurse.

 

The School Board may utilize an unlicensed diabetes care assistant to provide appropriate care to a diabetic student, or assist a student with self-care of his/her diabetes, in accordance with the student’s diabetes management and treatment plan, the student’s IHP, and regulations contained in Health and Safety, Bulletin 135.  An unlicensed diabetes care assistant is defined as a school employee who is not a healthcare professional, who is willing to complete training requirements established by BESE, and is determined competent by the school nurse to provide care and treatment to students with diabetes.  An unlicensed diabetes care assistant also means an employee of an entity that contracts with the school or school system to provide school nurses who are responsible for providing health care services required by law or the Department of Education.

 

In accordance with the student’s diabetes management and treatment plan, the student shall be permitted to self-manage his/her diabetes care as outlined in the student’s management and treatment plan.

 

With written permission of a student’s parent or legal guardian, a school may provide a school employee with responsibility for providing transportation for a student with diabetes, or supervising a student with diabetes with an off-campus activity.  An information sheet with pertinent information about the student’s condition and contact information in cases of emergency shall be provided the employee.

1. The supply of auto-injectable epinephrine to be kept in each classroom.
   
   

2. Written authorization for the student to be administered the medication.
   
   

3. Written certification from the student's licensed medical physician or other authorized prescriber that the student is at high risk of having anaphylaxis and is not capable of self-administration of auto-injectable epinephrine.
   
   

4. A written treatment plan, as defined above from the student's licensed medical physician or other authorized prescriber for managing anaphylactic episodes.

The required documentation shall be kept on file in the office of the school nurse or other designated school official.

 

The teacher in each classroom where auto-injectable epinephrine is stored shall be provided information regarding accessing and administering auto-injectable epinephrine, the signs and symptoms of anaphylactic reactions and specific information regarding condition, care, and treatment of the student assigned to the classroom who is at high risk of anaphylactic reaction.

 

The School Board or designee shall inform the parent or other legal guardian of the student in writing that the school and its employees shall incur no liability as a result of any injury sustained by the student from the good faith administration of auto-injectable epinephrine.  The parent or other legal guardian of the student shall sign a statement acknowledging that the school shall incur no liability and that the parent or other legal guardian shall indemnify and hold harmless the school and its employees against any claims that may arise relating to the good faith administration of auto-injectable epinephrine.

 

This information shall be included in the student handbook of each school and posted on each school’s website.  Such policy shall also be disclosed to any parent or other legal guardian who notifies the school in which the student is enrolled, in writing, that the student has a condition which puts him at risk of anaphylaxis.