Cobb County School District Administrative Rules
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Student Welfare: Medication
(See Form JLCD-1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 , 12, 13 & 14)		 JLCD 3/14/07


RATIONALE/OBJECTIVE:

The Cobb County School District (District) recognizes concerns for the welfare of students from their entry on a school bus or school property to their return to the bus stop or when they leave school property as well as during all school-related activities. Therefore, the District takes measures to provide monitoring, storage and administration of medication to students with medical conditions. Medication is dispensed by a licensed nurse or other employee who has successfully completed clinic orientation training provided by the District’s Consulting Nurses or school employees trained and authorized by the District’s county-wide Special Education Nurses (Trained Personnel).

RULE:

Medication shall be maintained and dispensed in accordance with the following provisions and the School Nursing/Clinic Procedures (Form JLCD-1):

I. TRANSPORTATION OF MEDICATION:
    A. Controlled substances may not be transported to school or returned home by U.S.    

        mail or other delivery service.
    B. A parent, legal guardian, or designated adult is responsible for transporting
        prescription medication to and from school in the original container and completing
        appropriate School Clinic (clinic) forms except as provided in Section IV below.
    C. School employees and/or bus drivers shall not assume liability for transporting
        medication except during school sponsored activities, such as field trips.
    D. A parent or legal guardian is responsible for transporting medications and completed
        authorization forms to alternative learning sites, such as Central Alternative or the
        Transitional Learning Center.

     E. See Section VIII for consideration for special education students.

 

II. LABELING/IDENTIFICATION:
    A. Medication sent in an unlabeled container will not be given.
    B. Prescription Medication:
        1. Shall be sent to school in the original pharmacy container labeled with the following
            information:
            a. Name of the student.
            b. Name and address of the pharmacy dispensing the medication.
            c. Name of the health care provider prescribing the medication.
            d. Date the prescription is dispensed.
            e. Name of the medication, either brand or generic.
            f. Strength of the medication.
            g. Route of administration.
            h. Frequency of administration.
            i. Instructions for use

        2. The original container must be stored in the clinic.

        3. Expired prescription medication will not be administered.
        4. When the prescription is unclear or insufficiently specific (i.e., “use as directed”),

            the School Nurse is to send a letter (Form JLCD-14 [Sample Letter for Unclear or

              Insufficiently Specific Prescription]) to the student’s parent/guardian indicating that

            the prescription is insufficient and asking for more specific doctor’s orders,

            including the frequency and dosage. A copy of this letter is to be placed in the

            student’s clinic file.      

 

    C. Over-the Counter (OTC) Medication:
        1. OTC shall be sent to school in the original manufacturer’s container. The
            manufacturer’s label must include:
            a. Name of the medication, either brand or generic
            b.  Strength of the medication
            c.  Instructions for use
            d.  Name of the student, legibly written
        2. Elementary and Middle School:

            a. The original container must be stored in the clinic, unless the OTC medication is

                specifically allowed to be carried on the student’s person as provided in Section

                III, below.

            b. Expired OTC medication will not be administered
        3. High School:

            High school students may carry OTC medication on their persons for their personal

            use.     

 

III. MEDICATION STORAGE:
All medications required to be stored in the clinic must be kept in a locked cabinet within a secured area with access limited to authorized personnel at all times. Exceptions are:
    A. Prescribed asthma medication
    B. Prescribed epinephrine auto injectors
    C. Prescribed diabetic medication
    D. Elementary and Middle School Students:

         The following are over-the-counter medications which elementary/middle school

         students may transport and carry with parent permission for their own personal

         use (Form JLCD-7, “Over-the-Counter Medication Form”):
        1. Elementary School Students:

            Cough and throat lozenges.
        2. Middle School Students:
            a. Acetaminophen (generic) and it’s various brand names, i.e., Tylenol.
            b. Antacids

            c. Aspirin

            d. Cough and throat lozenges.

            e. Ibuprofen (generic) and it’s various brand names, i.e., Motrin, Advil.
            f. Midol
        3. All other over-the-counter medications not listed must be stored in the clinic and

            administered by Trained Personnel. (See Section IV and Form JLCD-2,

            “Authorization to Give Medication at School”). This includes nicotine replacement

            therapies, such as:
            a. Nicotine gum and candy.
            b. Nicotine lozenges.
            c. Nicotine patches.
            d. Nicotine inhalers.
            e. Nicotine nasal sprays.

    E. High School Students:

        High school students may transport and carry any over-the-counter   

        medications for their personal use.         

 

IV. MEDICATION ADMINISTRATION DURING THE SCHOOL DAY:
    A. Written permission from the parent/guardian is required in order for Trained

        Personnel to administer each medication to the student (Form JLCD-2).
    B. General Provisions:
        1. Medications, including over-the-counter medications (i.e. Tylenol, Advil, antibiotic
            ointments, calamine lotion, cough drops, etc.) will not be supplied by the school or
            school employees.
        2. It is suggested that the first dose of a new medication should be administered at
            home prior to the child coming to school.
        3. Only medications that have a required dose or that may be required during school
            hours will be stored and administered.
        4. Changes in dosage or time of assistance with the administration of medication are
            only permitted with written authorization from:
            a. Over-the-Counter: The parent/legal guardian.
            b. Prescription: Both the parent/legal guardian and the licensed health care
                provider.
        5. Parents/legal guardians shall be notified when medication is running low.
    C. Prescription Medication: A prescription from a health care provider legally          

        authorized to prescribe medication in Georgia is required for all prescription

        medication. A health care provider can be any person, agency, department, or other

        entity that is legally authorized to provide health care services.

        1. The pharmacy label may be used as the health care provider’s written directions.
        2. Students who are new to the District and bring in prescription medications ordered
            by legal prescribers from states other than Georgia will be allowed thirty days to
            obtain new prescriptions from a health care provider licensed to prescribe
            medication in Georgia.
        3. Medication samples must have a written prescription or a licensed health care
            provider’s written order or note bearing the student’s name.
    D. Over-the-Counter Medications:
        1. May not be administered in doses that exceed established amounts for age or
            weight as printed on the manufacturer’s label.
        2. Over-the-counter medications will only be given for a maximum of ten consecutive
            school days.
        3. Switching to another variation of an over-the-counter medication for treatment of
            the same symptom will not extend the ten day limit.
    E. Administration of Medication: Only Trained Personnel shall provide medication
        administration or assistance with administration of medication, except as provided in
        Section V below.
        1. Students shall not be allowed to assist in the administration of any medication,
            whether prescription or over-the-counter, to another student in the clinic under
            any circumstances, including:
            a. Unlocking the medication cabinet.
            b. Handing out a medication tray or individual medicine container.
            c. Marking in the medication log.
            d. Any similar handling of medication for other students, regardless of their age or
                ability.
        2. A student, with the approval of their licensed health care provider and parent, may
            carry and self-administer the following prescription medications (See Form

            JLCD-10, “Authorization for Student to Carry Prescription Asthma Medication,

            Epinephrine Auto Injector, or Diabetic Medication”):
            a. Asthma medication.
            b. Epinephrine auto injector.
            c. Diabetic medication.
        3. Elementary/Middle School students may transport and carry certain specified

            over-the-counter medication with parent permission. (See Section III and Form

            JLCD-7, “Over-the-Counter Medication Permission Form”) All other over-the-

            counter medications not listed in Section III must be stored in the clinic and

            administered by Trained Personnel.
        4. Only licensed nursing personnel are permitted to administer injectable

            medication, with the exception of epinephrine auto injector(s).
    F. Off-Label Medication: Requests to administer off-label medication to students will be
        reviewed on a case by case basis.
    G. Experimental Medication: Requests to administer experimental medication to students
        will be reviewed on a case by case basis.
    H. Herbals: Over-the-counter diet pills, vitamins, and dietary supplements, including but
        not limited to minerals and herbs, will not be given.

 

V. MEDICATION ADMINISTRATION OUTSIDE REGULAR SCHOOL HOURS and/or    

    OFF CAMPUS:
    A. All medications, whether prescription or over-the-counter, must, unless there is a
        specific exception noted in this Rule, comply with all other District Rules concerning
        medication.
    B. After School Program (ASP):
        1. The principal, with input from the licensed school nurse, and the After School
            Program Director, will determine by whom and how medication will be secured and
            administered.
        2. The parent shall supply the school with a separate labeled prescription bottle
            specifically for ASP.
        3. All medication is to be brought to ASP directly by a parent/guardian or a school 
            staff member except for those medications listed in Section IV above. The ASP
            Director must be notified if a student is allowed to carry and self-administer any
            medication. Appropriate paperwork must be completed. Refer to School
            Nursing/Clinic Procedures (Form JLCD-1) for specifics.
    C. School Sponsored Activities, such as Field Trips:
        1. The principal, with input from the licensed school nurse, and the teacher
            sponsoring the field trip will designate the school employee (Principal’s Designee)
            who will administer medication during the field trip.
        2. The teacher sponsoring the field trip must provide the following information to the
            licensed school nurse or other Trained Personnel at least five days in advance of
            the field trip:
            a. Names of students participating in the field trip.
            b. Date/s and time of the trip.
            c. The name of any student(s) the teacher is aware of who must take their 
                medication with them.
            d. The name of any student(s) the teacher is aware of who requires a nurse to 
                accompany her/him to assist with the administration of an injectable or rectal
                medication or other procedure.
        3. The Trained Personnel must provide the following to the Principal’s Designee either
            the afternoon before or the morning of the field trip, based upon time of departure:
            a. Each medication in a separate labeled prescription bottle containing only
                necessary doses for the field trip.
            b. The names of any student(s) allowed to carry and self-administer their own
                medication.
            c. Any additional student specific information that may be needed or special
                circumstances that may arise on the field trip.

VI. MEDICATION DISTRIBUTION PROHIBITIONS:
Students may not share, sell, distribute, or possess with the intent to distribute any medication, whether prescription or over-the-counter. Students allowing another person to use their medications:
    1. Will be subject to the consequences specified in the CCSD Codes of Conduct.
    2. May have the privilege of carrying their medication revoked.

VII. SPECIAL EXCEPTIONS for MEDICATIONS:
    A. Required paperwork for each exception listed below must be completed by the  
        parent/guardian. Refer to School Nursing/Clinic Procedures (Form JLCD-1) for  
        specifics.
    B. Diabetic Medication:
        1. All insulin is considered injectable medication regardless of the delivery system, i.e.
            syringe or pump.
        2. An individual health care plan must be developed which:
            a. Outlines specific needs of the diabetic student.
            b. Is approved and signed by the licensed health care provider.
            c. Is signed by the parent/legal guardian.
            d. Is reviewed by a Consulting Nurse or county-wide Special Education Nurse.
        3. It is recommended that additional insulin and diabetic supplies be kept in the clinic.
    C. Epipens/Epinephrine Auto Injector:
        1. An individual health care plan must be developed which:
            a. Outlines specific needs of the student with a severe allergy requiring epinephrine
                auto injector and/or oral antihistamines e.g., Benadryl.
            b. Is approved and signed by the licensed health care provider.
            c. Is signed by the parent/legal guardian.
            d. Is reviewed by a Consulting Nurse or county-wide Special Education Nurse.
        2. The epinephrine auto injector and/or oral antihistamines will be carried in an  
            identifiable container, i.e. fanny pack, with a completed copy of the “Authorization
            for Student to Carry Prescription Asthma Medication, Epinephrine Auto Injector, or
            Diabetic Medication” form (Form JLCD-10).
        3. For younger students, the teacher may carry the epinephrine auto injector and/or
            oral antihistamines based on the individual health care plan of the student and the
            physical layout of the school building.
        4. It is recommended that a second epinephrine auto injector be kept in the clinic if
            the primary epinephrine auto injector is carried by the teacher or student.
    D. Asthma Medication:
        1. It is recommended that a second rescue inhaler be kept in the clinic if the primary
            rescue inhaler is carried by the student.
        2. Nebulizers with medication will be provided by the parent or legal guardian and will
            be kept in the clinic.
    E. Diastat/Diazepam Rectal Gel/Emergency Seizure Medication:
        1. Only licensed nursing personnel are permitted to administer diazepam rectal gel.
        2. A completed “Doctor’s Order for Administration of Diastat in the School Setting”
            form (Form JLCD-11) must be signed by a physician and maintained on file in the
            clinic.
        3. An individual health care plan must be developed which:
            a. Outlines specific needs of the student with a seizure disorder.
            b. Is approved and signed by the licensed health care provider.
            c. Is approved by the parent/legal guardian.
            d. Is reviewed by a Consulting Nurse or county-wide Special Education Nurse.

VIII. MEDICATION ADMINISTRATION FOR STUDENTS IN SPECIAL EDUCATION:
    A. Medication Administration for students who are classified as severely or profoundly    

        intellectually disabled, lower functioning moderately intellectually disabled,

        orthopedically impaired, severely behavior disordered or severely emotionally

        disabled; and/or are not able to administer their own medication must adhere to the

        following:
        1. The principal or designee will:
            a. Designate special education staff to administer medications to identified
                students.
            b. Designate additional personnel to be trained to assist with medication
                administration in the event of absence of the special education staff member.
            c. Notify designated personnel of the absence of the special education staff
                member.
        2. The county-wide Special Education Nurse will:
            a. Provide annual in-service training of special education staff and designated
                personnel who assist in medication administration.
            b. Provide appropriate continuous supervision of Trained Personnel.
            c. Consult with the principal and School Nurse if there are concerns regarding the
                selection of designated personnel for medication administration which may
                affect the physical health or safety of the identified student.
        3. Trained Personnel will:
            a. Administer medication in accordance with this rule.
            b. Maintain a current listing of students receiving medications that includes:
                1) The student’s name.
                2) The name and phone number of the licensed health care provider.
                3) The name, route, and dosage of the medication.
                4) The date initially prescribed or re-prescribed.
                5) The duration of the prescription.
                6) Specific instructions for administration including possible side effects,
                    adverse reactions, and/or contraindications.
            c. Provide information for a substitute teacher so that he/she may request Trained
                Personnel to assist with medication administration.
    B. Special Education students may require additional consideration with respect to the

        requirements of this Rule. This consideration may be made with the written

        permission of special education administrators.

IX. MEDICATION DISPOSAL:
    A. Any unused portion of a medication shall be destroyed if not personally collected by
        the parent or legal guardian within one week after:
        1. Expiration of the licensed health care provider’s order.
        2. Discontinuation of the medication.
    B. The school shall not be responsible for storing any medication or health care
        equipment over summer vacation.
        1. Parents will be sent the “Disposal of Medication(s) Notification Letter”
            (Form JLCD-5) two weeks before school ends.
        2. Parents must complete the form and return it to the Trained Personnel.
        3. All medication and health care equipment will be discarded on the last day of

            school if:
            a. The form is not returned to notify the Trained Personnel of the parent’s intent.
            b. The parent does not pick up the medication as he/she indicated on the form.
    C. Trained Personnel shall dispose of the medication and keep a record of all disposed
         medication on the “Medication Disposal Sheet” (Form JLCD-6).
         1. A second person is required to witness the Trained Personnel disposing of any
             medication.
         2. A log with the date, the student’s name, name and amount of the medication, and
             signature of the Trained Personnel and witness should be documented.

X. MEDICATION ERRORS:
See School Nursing/Clinic Procedures (Form JLCD-1).

XI. DEFINITIONS:
See School Nursing/Clinic Procedures (Form JLCD-1).

Adopted: 9/23/04
Revised: 6/1/05; 7/1/06; 12/14/06; 3/14/07