DEFINITIONS: For purposes of this policy, the definitions included in this section apply:

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1 STUDENTS Administrative Procedures 516A Administering Prescribed Medication in School Students may require prescribed medication at school in order to benefit from their educational experience. The following administrative procedures shall guide designated school personnel when dealing with students needing medication. DEFINITIONS: For purposes of this policy, the definitions included in this section apply: Licensed Medication Prescribers: (Cited from Minnesota Guidelines for Administering Medication in Schools, p. 10 May 2005, September 2005) Physician Advanced practice registered nurse with prescriptive authority (includes clinical nurse specialist practice, nurse-midwife practice, nurse practitioner practice, or registered nurse anesthetist practice) Physician s assistant who has direction from a physician or written protocol Dentist Podiatrist Osteopath Psychiatrist Who is not a licensed authorized prescribing practitioner in Minnesota? Licensed school nurse Registered nurse Licensed practical nurse Medical Assistant Nutritionist Psychologist Naturopathic Provider Chiropractor Licensed School Nurse licensed as Registered Nurse, Bachelor of Science Nursing/Bachelor of Arts Nursing, Public Health Certificate, MN Department of Education license 1. Notification School personnel will be notified either in writing or in person by parent/guardian and healthcare provider when students require prescribed medications at school. The licensed school nurse is the only staff person who can accept telephone orders from health care providers for prescribed medications to be administered at school. The

2 telephone orders need to be followed by written orders. Parents/guardians will complete "Authorization for the Administration of Medication and/or Treatment" form (NS13.03) when a prescribed medication is brought to school or within two school days. A completed Healthcare Providers Order for Administration of Medication by School Personnel form (NS13.09) is required. The original request of a parent may be oral or in writing. 2. Administering Prescribed Medication Prescription medication will be administered at school only if there is no reasonable alternative. It is usually possible to manage prescribed medication at home (medication prescribed two or three times per day may be given before school, after school and at bedtime). No prescribed medication will be administered without notification and prior approval of the licensed school nurse. Administration of prescribed medicine is to be done only by the licensed school nurse or delegated personnel. Students observed by school personnel self-administering any unauthorized medication will be reported to the licensed school nurse who will review the medication policy with the student and parents/guardians and take appropriate action. Over the Counter Medication Prescribed medication will only be administered at school when accompanied by a healthcare provider s order (M.S. 121A.22), parent permission and in a pharmacy labeled container, thus making the medication a prescription. Students observed by school personnel self-administering any unauthorized medication will be reported to the licensed school nurse who will review the medication policy with the student and parents/guardians and take appropriate action. Emergency Medication Medication may be required for students with certain medical conditions (see Administrative Procedures 516B). Complimentary Alternative Medicines (CAMS)

3 Complimentary Alternative Medicines may be administered at school at the discretion of the licensed school nurse. Upon the nurse s approval the prescribed medication must be accompanied by a *licensed medical providers order, parent authorization, provided in a properly labeled bottle and include a fact sheet containing dosage requirements, indications and contraindications. Parents will sign a release of information form for the medical provider so the licensed school nurse may communicate with him/her. Directly Observed Therapy (DOT) Directly observed therapy for the treatment of a health condition (i.e. Tuberculosis) may be administered at school in collaborative arrangement with county public health nurses (see Administrative Procedures 516C). 3. Supply and Labels Prescribed medication must be brought to school by a parent or responsible adult at elementary level and may be brought by the student at the secondary level. If there is prescribed medication remaining at the end of the school year/program, arrangements must be made for it to be picked up by the parent or responsible adult unless prior arrangements have been made with a licensed school nurse. In secondary schools, prescribed medications may be sent home with the student as long as prior arrangements are made with the health office. Prescribed medication not picked up within 7 business days will be taken to a drop off site (i.e. police department) for disposal. It is the parent's/guardian's responsibility to provide school personnel with prescribed medication that is pharmacy labeled. The containers must have the name of the student, the name of the healthcare provider, the name and dosage of the medication, directions for administering the prescribed medication at school and the date filled. Administering the prescribed medication will be done by delegated school personnel according to the information printed on the pharmacy label and to the healthcare provider s orders. Mixed dosages in a single container will not be accepted for administration at school. Prescribed medication cannot be given if labeling is inadequate or the prescription is outdated (must be within 12 months). Changes in dosage will not be made without a new health care provider order and a new parent/guardian request form completed. Parents/guardians are expected to notify the school, in writing, when the prescribed medication is discontinued. If the medication is resumed, a new consent form must also be received. The licensed school nurse will notify the healthcare provider if parent requests to discontinue medications (NS13.19). If a parent/guardian or healthcare provider instructs the student to carry the prescribed medication and self-administer, written authorization must be on file from the parent/guardian and healthcare provider. The authorization must specifically state the

4 student is to carry the prescribed medication on his/her person and self-administer. The licensed school nurse will review the request and determine if the student is able to self administer the prescribed medication in a safe and efficient manner. 4. Students with Disabilities The licensed school nurse must be part of the team when considering medication as part of an IEP or 504 plan. 5. Training It is the licensed school nurse s responsibility to review prescribed medications and train personnel administering prescribed medications. All personnel administering prescribed medication will annually review the District s guidelines for administering prescribed medication with a licensed school nurse. The licensed school nurse will verify that personnel administering prescribed medication understand the District s guidelines. 6. Field Trips In the event of a field trip, trained staff may be assigned the responsibility for the handling and administration of prescribed medications. 7. Storage For security purposes, all prescribed medication will be stored at a central, locked location within the health office. Any alternate plan for storing prescribed medication must have the approval of the licensed school nurse. Only authorized personnel will be allowed to remove prescribed medication from the central locked area. Administering of emergency medications will be governed by Board Policy No. 516, Administering Medication in School, and Administrative Procedures 516.B, Administering Emergency Medications in School. 8. Transportation Between Buildings and Programs It is the parent s/guardian s responsibility to transport prescribed medication from one building/program to another. In the event this is not feasible, a licensed school nurse can transport to another building/program following approval of parent/guardian. When transportation occurs to and from a building/program, it will be completed within the same school day. ATTACHMENT: St. Cloud Area School District 742 Authorization for the Administration of Medication and Treatment - Form #NS13.03

5 St. Cloud Area School District 742 St. Cloud, MN Administrative Procedures Date: November 30, 1995 Revised: April 26, 2001 Revised: June 27, 2002 Revised: July 23, 2015

6 ST. CLOUD AREA SCHOOL DISTRICT 742 Public and Non Public Schools AUTHORIZATION FOR THE ADMINISTRATION OF MEDICATION AND/OR TREATMENT THE PURPOSE OF THIS CONSENT FORM IS TO AUTHORIZE THE SAFE AND NECESSARY ADMINISTRATION OF MEDICATION AND TREATMENTS IN SCHOOL AND TO AUTHORIZE PROFESSIONAL CONSULTATION WITH THE PRESCRIBING LICENSED PRACTITIONER ABOUT THIS ORDER. ORDERS MUST BE RENEWED ANNUALLY OR WHENEVER THERE IS A CHANGE IN MEDICATION, DOSAGE OR FREQUENCY. Parents/guardians will complete Authorization for the Administration of Medication and/or Treatment form (NS13.3) when a medication is brought to school, or within one school day. Medication must be brought to school by a parent or responsible adult. Prescribed medication can be administered at school only if there is no alternative and when accompanied by a physician s order and in a pharmacy labeled container. Non prescription (over the counter) medication may only be administered at school when accompanied by a physician s order and in a pharmacy labeled container. Administration of drugs and medicine is to be done only by the licensed school nurse or delegated personnel. Dietary supplements and non FDA approved alternative medications will not be administered at school. It is the parent s/guardian s responsibility to provide school personnel with medication that is pharmacy labeled. The containers must have the same name of the student, the name of the physician, the name and dosage of the drug, directions for administering the medication at school and the date filled. Parents/guardians will be contacted if labeling is inadequate or the prescription is outdated. I hereby request the licensed school nurse, or other authorized personnel, to give medication as prescribed by a physician and/or requested by a parent, to the child described below. I release the school personnel from liability in the event any reaction results from the named medication. This authorizes the licensed school nurse to contact the physician for any further information needed regarding the medication or the condition being treated. Signature of Parent/Caregiver Date Birthdate Name of Student School Grade/Teacher Name of Parent/Caregiver Home Phone Cell Phone Name of Doctor Telephone Clinic Name Fax Number Diagnosis Name of Medication Time of Day to be Given Amount *My child takes the following prescriptions at home: Medication Dosage Times Licensed School Nurse Approval Signature Date NS /17/11

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