The Connecticut General Assembly

OFFICE OF LEGISLATIVE RESEARCH

January 30, 1997 97-R-0225

TO:

FROM: John Kasprak, Senior Attorney

You want information on regulations concerning administration of medications to students in schools. You are particularly interested in the administration of aspirin.

SUMMARY

According to Department of Public Health (DPH) regulations, giving medications to students in schools is allowed but not required. The local or regional board of education must determine if this practice is to be allowed in its schools. If so, it must establish specific written policies and procedures on administration of medications to students by a school nurse, or by principals or teachers in the absence of the school nurse.

No medications can be given to a student without the written order of a physician, dentist, advanced practical registered nurse, or physician assistant.

The regulations also allow for self medication by students if certain procedures and policies are developed and followed.

Previously, aspirin could be given to students in schools if they had their parents' written authorization. A 1990 public act requires the written order of a licensed medical practitioner as well as the parents' authorization.

ADMINISTRATION OF MEDICATIONS TO STUDENTS

Authorization, Policies, and Procedures

State Department of Public Health (DPH) regulations provide that the administration of medications is not required in schools; the local or regional board of education must make that determination (Regs. § 10-212a-2(a)). Specifically, the board must determine (1) if medications can be administered in schools under its jurisdiction; (2) if so, who is authorized to give them (licensed medical personnel only, or in their absence, principals and teachers); and (3) whether to allow self-medication by students (§10-212a-2(a)).

If a board of education allows the administration of medication in its schools, then the following apply: (1) the board, with the advice and assistance of the school medical advisor (a physician) and school nurse supervisor, must establish written policies and procedures for administration of medications by a nurse, or in her absence, by a principal or teacher; (2) the board must submit these policies and procedures to DPH for review and approval; and (3) the board, with the advice and assistance of the school medical advisor and nurse supervisor, must review and revise the policies and procedures as needed, but at least biennially (such changes must also be reviewed and approved by DPHS (§ 10-212a-2(b)).

Requirement of a Written Order From a Prescriber

In order to administer medications to students, there must be a written order from an authorized prescriber, and the written authorization of the student's parent or guardian (§ 10-212a-2(c)). Prescribed medication can be administered only to the person for whom the prescription is written (§ 10-212a-2(d)). An “authorized prescriber” is a physician, dentist, advanced practice registered nurse, or physician assistant (§ 10-212a-1(3)).

If there is no licensed nurse available, only principals and teachers with the proper training can administer medications to students. They can administer oral, topical, or inhalant medications. Injectable medications can be administered by a principal or teacher only to a student with a medically diagnosed allergic condition which may require prompt treatment to protect the student against serious harm or death. Principals and teachers may not administer investigational drugs (drugs that are being scientifically tested and clinically evaluated to determine their efficiency and safety and have not yet received FDA approval, § 10-212a-2(e)).

Emergency Situations

A local board of education allowing the administration of medications to students must establish policies and procedures to follow if a medication emergency occurs and ensure that the following information is readily available in the schools: (1) the local poison information center telephone number, (2) the procedure to follow in case of an emergency, and (3) the name of the person responsible for decisions in the absence of the school nurse (§ 10-212a-2(f)).

All Schedule II through V controlled drugs may be administered in schools according to board of education policy (see attached). Controlled drugs are “grouped” in Schedules 1 through V according to their decreasing tendency to promote abuse or dependency. Schedule 1 drugs are the most strictly controlled.

Self Medication

Students who are able to self administer medication may do so if approved by the board of education and if (1) an authorized prescriber writes an order for self administration; (2) there is written authorization from the student's parent or guardian; (3) the school nurse has evaluated the situation and deemed it safe and appropriate, has documented it in the student's health record, and developed a plan for general supervison; (4) the principal and appropriate teachers are informed that the student is self administering; and (5) the medication is transported to the school and maintained under the student's control according to the board's policy (§ 10-212-46). Medication for a student cannot be stored at a school without a current written order from an authorized prescriber (§ 10-214a-5).

RECENT LEGISLATION ON ADMINISTRATION OF MEDICATION TO STUDENTS

Public Act 88-360 authorized a school nurse, principal, or teacher to administer aspirin, ibuprofen, or an aspirin substitute containing acetaminophen to any student according to the written authorization of the child's parent or guardian. This legislation originated in the Education Committee.

PA 90-85 prohibited school nurses, teachers, and principals from giving aspirin, ibuprofen, or aspirin substitutes to students without the written order of a licensed physician or dentist and the written authorization of the child's parents. This legislation began in the Public Health Committees and was also considered by the Education Committee.

PA 94-103 allowed a nurse employed by, or providing services under the direction of a local school board at a school-based health clinic, to administer medications to students in the absence of a school nurse. The Public Health and Education Committees considered this legislation.

Also in 1994, PA 94-213 authorized the administration of medications to students pursuant to written orders of an advanced practice registered nurse authorized to prescribe, or a physician assistant authorized to prescribe. Again, the Public Health and Education Committees were involved.

JK:pa

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