Oregon Administrative Rules
Chapter 581 - OREGON DEPARTMENT OF EDUCATION
Division 21 - SCHOOL GOVERNANCE AND STUDENT CONDUCT
Section 581-021-0037 - Administration of Medication
Universal Citation: OR Admin Rules 581-021-0037
Current through Register Vol. 63, No. 9, September 1, 2024
(1) As used in this rule, definitions of terms shall be as follows:
(a) "Adrenal crisis" means adrenal crisis as
defined in ORS 433.800.
(b) "Adrenal insufficiency" means adrenal
insufficiency as defined in ORS
433.800.
(c) "Asthma," as defined in ORS
339.866.
(d) "Delegation" means a formal delegation of
a nursing procedure by a registered nurse to district personnel in accordance
with the Oregon Nurse Practice Act (OAR Chapter 851).
(e) "Designated personnel" means the school
personnel designated and trained to administer medication pursuant to district
policy and procedure.
(f)
"District" means public school district, education service district, or charter
school.
(g) "Drug" means drug as
defined in ORS 689.005.
(h) "Medication" means medication as defined
in ORS 339.867.
(i) "Nonprescription medication" means
nonprescription drugs as defined in ORS
689.005.
(j) "Notice of a diagnosis of adrenal
insufficiency" means written notice to the district from the parent or guardian
of a student who has been diagnosed as adrenal insufficient with a copy of an
order from the student's primary care provider that includes the student's
diagnosis, description of symptoms indicating the student is in crisis,
prescription for medication to treat adrenal insufficiency crisis, and
instructions for follow-up care after medication to treat adrenal insufficiency
crisis has been administered.
(k)
"Prescriber" means a "Practitioner" as defined in ORS
689.005.
(l) "Prescription medication" means a
"Prescription Drug" as defined in ORS
689.005. (m) "Severe allergy"
means a severe allergy as defined in ORS
339.866.
(m) "Short-acting opioid antagonist," means
short-acting opioid antagonist as defined by ORS
689.800.
(2) Districts shall adopt policies and procedures that provide for:
(a) The
administration of medication to students by designated personnel;
(b) Medications, including injectable
medications, may be administered by district personnel as part of a formal
delegation by a Registered Nurse.
(c) The administration of medication by a
student to themselves without assistance from designated personnel.
(3) Policies or procedures for the administration of medication to students by designated personnel shall:
(a) Include a process to designate and
supervise appropriate district personnel that takes into account when a student
is in school, at a district-sponsored activity, under the supervision of
district personnel, or in transit to or from school or district-sponsored
activities;
(b) Ensure designated
staff have received medication administration training and have access to a
school nurse as per OAR
581-022-2220;
(c) Require designated personnel to
successfully complete annual training on the administration of medication in
accordance with the following requirements;
(A) Training for designated personnel must be
provided by a person who is familiar with the delivery of health services in a
school setting and who is:
(i) A Registered
Nurse licensed by the Oregon State Board of Nursing; or
(ii) A prescriber.
(B) District shall use training developed by
the Oregon Health Authority (OHA) for district personnel to administer
epinephrine, glucagon, and medication to treat adrenal insufficiency as
required in ORS 333.055,
433.810,
433.815, and
433.830;
(C) Training for designated personnel to
administer medications to students must align with the ODE Medication
Administration Training and at a minimum include a discussion of applicable
district policy, procedures and materials, and include the following elements:
(i) Safe storage, administration, handling,
and disposing of medications;
(ii)
Accessibility of the medication during an emergency;
(iii) Record keeping;
(iv) Whether response to medication should be
monitored by designated personnel and the role of designated personnel in such
monitoring;
(v) Emergency medical
response procedures following administration of the medication;
(vi) Confidentiality of health information;
and
(vii) Assessment of gained
knowledge.
(D) The first
training for designated district personnel and every third training thereafter
must be provided in-person. During subsequent years, designated district
personnel may complete an online training so long as a trainer is available
following the training to answer questions and provide clarification.
(E) An online training may qualify as
"in-person" when these measures are met:
(i)
Content is provided via synchronous, interactive online sessions with the
trainer and learners visible on screen.
(ii) Trainers must be licensed and work
within their scope of practice.
(iii) Include in-person, skills demonstration
for training developed by the Oregon Health Authority for epinephrine,
glucagon, and for medication to treat adrenal insufficiency.
(F) District shall maintain
documentation of district personnel's completion of training as required by OAR
166-400-0010; and
(G) In alignment with district board policy,
any district personnel may be allowed to administer a non-injectable,
short-acting opioid antagonist to any student or other individual on district
premises who the personnel believe in good faith is experiencing an overdose of
an opioid drug without receiving medication administration training.
(d) Permit designated personnel to
administer prescription medication where:
(A)
Because of its prescribed frequency or schedule, the medication must be given
while in school, at a district-sponsored activity, while under the supervision
of school personnel, and in transit to or from school or district-sponsored
activities;
(B) The student's
parent or guardian has provided written permission. The district with written
instruction for the administration of the medication from the prescriber that
includes the name of the student, name of the medication, dosage, method of
administration, frequency of administration, any other special instructions,
and the signature of the prescriber. A prescription medication label prepared
by a pharmacist at the direction of a prescriber shall be sufficient if all of
the information required by this definition except for the prescriber's
signature is included.
(e) Permit designated personnel to administer
nonprescription medication where:
(A) The
nonprescription medication is necessary for the student to remain in
school;
(B) The nonprescription
medication is:
(i) Provided in the original
manufacturer's container by the student's parent or guardian; or
(ii) Is part of a district's stock medication
program in compliance with the Oregon Board of Pharmacy rules including OAR
855-035-0005.
(C) The student's parent or
guardian has provided written instruction for the administration of the
nonprescription medication that includes the name of the student, name of the
medication, dosage, method of administration, frequency of administration, any
other special instructions, and signature of the student's parent or guardian.
If the written instruction is not consistent with the manufacturer's guidelines
for the nonprescription medication, the written instruction must also include a
written order allowing the inconsistent administration signed by a prescriber;
and
(D) For nonprescription
medication that is not approved by the Federal Drug Administration, a written
order from the student's prescriber that includes the name of the student, name
of the medication, dosage, method of administration, frequency of
administration, a statement that the medication must be administered while the
student is in school, any other special instructions, and the signature of the
prescriber.
(f) Include
procedures for the administration of premeasured doses of epinephrine by the
trained district personnel to any student or other individual on district
premises who the personnel believe in good faith is experiencing a severe
allergic reaction, regardless of whether the student or individual has a
prescription for epinephrine as provided by ORS
433.815;
(g) Include procedures for the administration
of medication by district personnel to treat a student who the personnel
believe in good faith is experiencing symptoms of adrenal crisis. The
procedures must provide that:
(A) Per ORS
339.869, only upon notice of a
diagnosis of adrenal insufficiency as defined in this rule, the building
administrator of the school the student attends will designate one or more
district personnel to be responsible for administering medication to treat
adrenal insufficiency in the event the student exhibits symptoms that district
personnel believe in good faith indicate the student is experiencing symptoms
of adrenal crisis;
(B) The
designated personnel will successfully complete training to administer
medication to treat a student who has adrenal insufficiency and is experiencing
symptoms of adrenal crisis in accordance with rules adopted by the Oregon
Health Authority;
(C) The student's
parent or guardian must provide adequate supply of the student's prescribed
medication to the district; and
(D)
In the event that a student experiences symptoms of adrenal crisis and the
designated personnel determines the medication to treat adrenal insufficiency
should be administered, any available district personnel will immediately call
911 and the student's parent or guardian.
(h) Address the following for the
administration of medications including medications that are self-administered
by students:
(A) Safe storage, accessibility
of medications during an emergency, methods for administration, handling, and
disposing of medications;
(B)
Record keeping;
(C) Whether student
response to medication should be monitored by designated personnel and the role
of designated personnel in such monitoring;
(D) Emergency medical response for life
threatening side effects and allergic reactions, including the administration
of premeasured doses of epinephrine;
(E) Initiating emergency medical response
when epinephrine or a short-acting opioid antagonist is administered to any
student or other individual on district premises is administered; and
(F) Confidentiality of student health
information contained within the education record.
(4) Policies and procedures for the administration of medication by a student to themselves without assistance from designated personnel shall:
(a) Permit a
student to administer prescription or nonprescription medication to themselves
where the student can demonstrate the ability, developmentally and
behaviorally, to self- administer medication and has permission to
self-administer medication from a school building administrator, and a
prescriber or registered nurse practicing in a district setting;
(b) Require parental or guardian
consent;
(c) For nonprescription
medication that is not approved by the Federal Drug Administration, require a
written order from the student's prescriber that includes the name of the
student, name of the medication, dosage, method of administration, frequency of
administration, a statement that the medication must be administered while the
student is in school, at a district-sponsored activity, under the supervision
of district personnel, or in transit to or from school or district-sponsored
activities, any other special instructions, and the signature of the
prescriber;
(d) Require that backup
medication, if provided by a student's parent or guardian, be kept at the
student's school in a location to which the student has immediate access in the
event the student has an asthma or severe allergy emergency per ORS
339.866;
(e) Include process for a district to revoke
its permission for a student to self-administer medication if the student does
not responsibly self-administer the medication or abuses the use of the
medication; and
(f) Include a
process for determining if or when a student may self-carry prescription
medication when the student has not been approved to self-administer
medication.
(5)
(a) A district may adopt policies and
procedures to allow school district personnel to administer a short-acting
opioid antagonist medication to any student or other individual who the
district personnel believe in good faith is experiencing an overdose of an
opioid drug.
(b) A district shall
provide to the parent or legal guardian of each minor student enrolled in a
school in the district information regarding short-acting opioid antagonists.
The information described in this subsection must include at least:
(A) A description of short-acting opioid
antagonists and their purpose;
(B)
A statement regarding, in an emergency situation, the risks of administering to
an individual a short-acting opioid antagonist and the risks of not
administering to an individual a short-acting opioid antagonist;
(C) A statement identifying which schools in
the district, if any, will have short-acting opioid antagonists, and the
necessary medical supplies to administer short-acting opioid antagonists, on
site and available for emergency situations; and
(D) A statement that a representative of a
district may administer to a student a short -acting opioid antagonist in an
emergency if the student appears to be unconscious and experiencing an opioid
overdose.
(c) A school
district board shall ensure that the parent or legal guardian of a minor
student enrolled in a school within the school district is immediately notified
when a short-acting opioid antagonist is administered to the student if the
short-acting opioid antagonist is administered while the student is at school,
on school property under the jurisdiction of the school district or at any
activity under the jurisdiction of the school district.
(6) District personnel shall not recommend to a parent or legal guardian of a student that the student seek a prescription for a medication that is prescribed with the intent of affecting or altering the thought processes, mood or behavior of the student.
(7) District personnel shall not require a child to obtain a prescription for a substance covered by the Controlled Substances Act, 21 U.S.C. 801 et seq., as a condition of attending school, receiving an evaluation to determine eligibility for Section 504 of the Rehabilitation Act of 1973, early childhood special education or special education under ORS chapter 343 or receiving early childhood special education or special education services.
(8) District shall allow the application of and use by students of nonprescription sunscreen, including sunscreen that contains para-aminobenzoic acid, without any required documentation from a licensed health care professional per ORS 339.874.
(9) A registered nurse who is employed by a district or a local public health authority as defined in ORS 431.003 to provide nursing services at a district may accept an order from a physician licensed to practice medicine or osteopathy in another state or territory of the United States if the order is related to the care or treatment of a student who has been enrolled at the district for not more than 90 days.
Statutory/Other Authority: ORS 326.051
Statutes/Other Implemented: ORS 339.866, ORS 339.867, ORS 339.869, ORS 339.870, ORS 339.871, ORS 339.873, ORS 339.874 & ORS 678.038
Disclaimer: These regulations may not be the most recent version. Oregon may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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