[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

[IP] Big Hammer

> who do I contact to file a
> formal complaint against the doctor and school nurse?  We are part
> of Los Angeles Unified School District, and I'm just afraid if I let
> them handle the whole matter, it will just get buried.  I'm not
> interested in a law suit, or want money out of this.  I just want to
> make sure they never do this kind of thing to one of our children
> ever again.
Call the office of the State Superintendent of Public Instruction. 
Her name is Delaine Eastin -- everybody in the Calif. school system 
works for her. Get the name and phone number for the "special needs 

I copy the Superintendent's letter to all District and County 
Superintendents to you. There is no excuse for what they did and no 
defense either.

email @ redacted


September 5, 1997

             District and County Superintendent of Schools
             Directors of Special Education
             Attn: Credentialed School Nurses

Dear Colleague: 

I am committed to providing a healthy, safe, and supportive
environment for all students attending school. Accordingly, the
purpose of this letter is to help you address issues regarding the
administration of medications by school personnel. I have heard from
health care professionals, parents, and teachers who wish
clarification on how students should receive prescribed medications
while at school. The ability to access necessary prescribed medication
during the school day is critical to the educational achievement of
many children in California. 


Students with acute or chronic illnesses may require prescribed
medications (Medications should be prescribed only by a physician
licensed in California.) during school hours to benefit from the
educational program. Some local educational agencies or nonpublic
schools are interpreting the law authorizing the administration of
necessary medications to be permissive and, therefore, are refusing to
administer prescribed medications at school. Sufficient justification
exists in federal laws (Section 504 of the Vocational Rehabilitation
Act of 1973 [Public Law 93-112]; Title II of the American with
Disabilities Act of 1990 [Public Law 101-336]; The Individuals with
Disabilities Education Act [as amended by Public Law 105-17]) to
permit administration of medications to students while in school. 

Additionally, some local educational agencies are allowing untrained
and unsupervised personnel to administer medications. This practice
has included students dispensing medication to other students, which
is contrary to California law. Conversely, some local agencies are not
allowing students to carry on their person or to self-administer
prescribed emergency medications, such as asthma inhalers, insulin,
severe allergic reaction kits, and anticonvulsives. 

Local educational agencies should adopt policies and procedures to
enable students to receive medications while attending school. All
medications administered at school must be prescribed by a physician
even if they are sold over the counter. 


The following sections of this letter address issues of requesting
administration of required medications at schools, administering and
training personnel to administer those medications, documenting the
medications administered to students and disposing of unused

Requesting Administration of Required Medications at School

Parents or guardians must complete a written request for medication to
be administered at school. Parent permission forms that include hold
harmless or waiver components are not recommended, as they constitute
a disincentive for parents to comply with medication administration
procedures. Furthermore, they do not provide immunity to school
districts for inappropriate or negligent administration of medication.
Parent permission and physician authorization forms must be completed
for all medications, including those purchased over the counter. The
student's physician must provide a written statement detailing the
amount of medication and the method and time schedules by which the
medication is to be taken. Requests for administering required
medication at school should be updated annually or more frequently if
there is a change in the medication, dosage, or time schedule. 

In addition, parents or guardians must provide the medication in a
container labeled by a California pharmacist or, in the case of an
over-the-counter medication, in the original container and should
deliver the medication to the school personally or send it with a
designated adult. There may be an exception for students in special
education programs for whom arrangements have been made with the bus
driver or other adult transportation provider. 

The parent or guardian and physician should be advised to discuss
arranging medication times during out-of-school hours if possible. It
is, however, understood that some medications must be prescribed for
administration during regular school hours. All educational agencies
are advised to offer this assistance to students. 

The credentialed school nurse or designated school employee should
maintain a list of students needing medication during regular school
hours. This list of students should be kept in the administrative or
health office for needed reference, and should be reviewed and updated
on an ongoing basis. 

Administering Medications

All students should receive necessary services and support from
personnel who have been appropriately trained by a credentialed school
nurse, public health nurse, or physician. Parents or a designated
staff member should administer medications according to the
physician's indicated dosage schedule and follow the guidelines for
administering the medication. A parent may come to school to
administer the medication on a prearranged schedule. Under certain
circumstances, a student may self-administer medications. 

Students who need medication while at school may carry emergency
medication (such as asthma inhalers, insulin, severe allergic reaction
kits and anticonvulsives) and self-administer such medication under
the supervision of school personnel, provided the following conditions
are met: (1) the student is physically, mentally, and behaviorally
capable, in the written opinion of the parent, physician, and
credentialed school nurse, to assume that responsibility and has been
adequately instructed at home; (2) the medication is necessary to the
student's health and must be taken during school hours; (3) the
student has successfully demonstrated self-administration of the
medication to the credentialed school nurse; and (4) supervision is
provided by the credentialed school nurse, when available, or by
designated school personnel. 

Documenting Medications Administered 

The student's health care requirements should be documented in an
individualized health and support plan (for Section 504 students) or
the individualized education program (for special education students).
A plan should be developed, evaluated and updated at least annually,
or whenever medications are changed, with the family, credentialed
school nurse, and other support personnel. The plan should become part
of the student's cumulative record. Students with acute conditions may
require administration of episodic medication. 

A log should be developed and maintained for recording medications
that are administered at school. This log documents all medications
administered and serves as protection for both the district and the

Training Personnel Administering Medications

All students should receive necessary services and support from
personnel who are authorized, trained, and supervised in administering
medications to students in school. School administrators should
designate those persons responsible for administering medications in
their schools. A credentialed school nurse should conduct an annual
in-service instruction for any staff member who will be administering

The in-service instruction should include the following topics: 

     1. Method of administration
     2. Contraindications of medications frequently ordered and any
     special drugs ordered 3. Possible signs and symptoms of adverse
     side effects, omission, or overdose 4. Proper handling and
     storage 5. Record keeping 6. Emergency procedures

Disposing of Unused Medications

If the medication changes during the school year, the remaining
medication should be given to the parent or guardian at the time of
delivery of the new medication. The parent or guardian should take any
remaining medication home at the end of the school year; medications
not claimed at the end of the school year should be discarded as
recommended by the local health officer and appropriate OSHA
guidelines. The medication log and authorization forms are to be
placed in the student's health folder component of the cumulative

Training videos and materials that can be used to assist schools are
available at cost through the California School Nurses Organization.
Contact the Organization at P. O. Box 292788, Sacramento, CA 95829; or
call toll free (888) 268-CSNO (2766). 

Should you have any questions or concerns regarding this
correspondence, please contact the California Department of Education,
Special Education Division, Specialized Populations Unit, at (916)

I encourage your support to provide necessary medications to students
when they are in school. Your attention and cooperation in this
important activity will help many students to become full partners in
all school curricular and extracurricular activities. I appreciate and
thank you for this commitment to our students. 


State Superintendent of Public Instruction
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
send a DONATION http://www.Insulin-Pumpers.org/donate.shtml