Virginia Administrative Code
Title 8 - EDUCATION
Agency 20 - STATE BOARD OF EDUCATION
Chapter 671 - REGULATIONS GOVERNING THE OPERATION OF PRIVATE SCHOOLS FOR STUDENTS WITH DISABILITIES
Section 8VAC20-671-710 - Medication and health
Current through Register Vol. 40, No. 16, March 25, 2024
A. Each student shall have on file evidence of a comprehensive physical examination prescribed by the State Health Commissioner from a qualified licensed (i) physician, (ii) nurse practitioner, or (iii) physician assistant acting under the supervision of a licensed physician. The examination must contain, at a minimum, information required on the Commonwealth of Virginia School Entrance Health Form.
B. Each student shall have an up-to-date certificate of immunization.
C. Any student or staff with a medical condition that is contagious or infectious shall take leave from school while in that condition unless attendance is approved by a qualified health care provider. Conditions meeting this requirement must be provided in the parent/student handbook or other print materials.
D. A first aid kit shall be maintained and readily accessible for minor injuries and medical emergencies in each building used for instruction or other school activity.
E. Each private school for students with disabilities shall develop a written policy related to its procedures to address students with severe allergies who may be at risk of an anaphylactic reaction necessitating the use of an epinephrine auto-injector. The policy shall address, but is not limited to (i) an overview of anaphylaxis and its symptoms; (ii) staff training in the possession and administration of epinephrine auto-injectors; (iii) standing orders; (iv) responding to anaphylaxis; (v) post administration of epinephrine actions; and (vi) storage, access, and maintenance. School administrators shall ensure that the school's policy is consistent with the Recognition and Treatment of Anaphylaxis in the School Setting guidelines dated June 28, 2012 that are published on the Virginia Department of Education's website.
F. Each private school for students with disabilities shall ensure that it has at least two auto-injectable epinephrine units in both dosage sizes, 0.3 mg for a student who weighs more than 66 pounds and 0.15 mg for a student who weighs 33 to 66 pounds, on school premises, to be administered by any employee of a school for students with disabilities licensed by the Board of Education who is authorized by a prescriber and trained in the administration of epinephrine to any student believed to be having an anaphylactic reaction. Stock epinephrine is intended for use on school premises and should not be carried offsite. Additional epinephrine should be made available along with arrangements for administration during field trips and other official offsite school activities.
G. Procurement and acceptance of medication.
H. The expiration date of epinephrine solutions shall be checked periodically but not less than monthly. The auto-injector unit should be replaced if it is approaching its expiration date. The contents should be inspected through the clear window of the auto-injector. The solution should be clear; if it is discolored or contains solid particles, discard and replace the unit. Used, expired, or epinephrine auto-injectors with discolored solution or solid particles shall not be used and shall be discarded in a sharps container. The school shall maintain a sufficient number of extra doses of epinephrine for replacement of used or expired school stock on the day it is used or discarded. Each school shall maintain documentation that its stock of epinephrine has been checked on a monthly basis to ensure proper storage, review of expiration dates, medication stability, and replacement upon use or disposal under the criteria in this subsection.
I. All medication and medical paraphernalia, with the exception of epinephrine auto-injectors, shall be properly labeled and securely locked or stored in accordance with the Virginia School Health Guidelines. Epinephrine auto-injectors must be stored in a safe, unlocked, and accessible location in a dark place at room temperature (between 59°F - 86°F). Epinephrine cannot be stored in a refrigerator. Although epinephrine should not be maintained in a locked cabinet or behind locked doors, precautions must be in place to ensure that the epinephrine auto-injectors are not readily available to student access. The location of the epinephrine must be clearly marked at the storage location, and staff must be made aware of the storage location in each school.
J. An individual medication administration record shall be maintained for each medication a student receives and shall include student name, date the medication is to begin, drug name, schedule for administration, strength, route, identification of the individual who administered the medication, and dates the medication was discontinued or changed.
K. Once epinephrine is administered, local Emergency Medical Services (911) shall be activated and the student transported to the emergency room for follow-up care. In some reactions, the symptoms go away, only to return one to three hours later. This is called a "biphasic reaction." Often these second-phase symptoms occur in the respiratory tract and may be more severe than the first-phase symptoms. Therefore, follow-up care with a health care provider is necessary. The student will not be allowed to remain at school or return to school on the day epinephrine is administered. The administration of epinephrine shall be treated as a serious incident and shall be reported to the parent or legal guardian immediately using all means of contact provided by the parent (i.e., home, cell, or work telephone number, email, or text message), but no later than the end of the school day. The school administrator shall ensure that an appropriate serious incident form is completed by the end of the day on which the administration of epinephrine occurred. The incident report shall include the following information:
L. The provider shall develop and implement written policies and procedures regarding:
M. The telephone number of a regional poison control center and other emergency numbers shall be posted on or near the phone.
N. Medication training.
O. Monitoring the supply of medications.
P. The requirements outlined in subsections F and K of this section related to the possession and administration of epinephrine extend to activities off the school premises. Therefore, school policies shall include specific protocols for responding to anaphylaxis in the school setting, both onsite and at offsite school events, such as field trips.
Q. In accordance with § 8.01-225A 13 of the Code of Virginia, any person who is an employee of a school for students with disabilities, as defined in § 22.1-319 of the Code of Virginia and licensed by the Board of Education, who is authorized by a prescriber and trained in the administration of epinephrine and who administers or assists in the administration of epinephrine to a student believed in good faith to be having an anaphylactic reaction, or is the prescriber of the epinephrine, shall not be liable for any civil damages for ordinary negligence in acts or omission resulting from rendering of such treatment. Whenever any employee is covered by the immunity granted in § 8.01-225A 13 of the Code of Virginia, the school shall not be liable for any civil damages for ordinary negligence in acts or omission resulting from such administration or assistance.
Statutory Authority: § 62.1-44.15 of the Code of Virginia.