1. PHILOSOPHY
   Weber School District (District) seeks to ensure all students are safe at school.  It is the intent of Weber School District that all students who need medication at school are able to receive such medication, and that the administration of medication to students complies with state and federal laws. The policy also informs staff how to act in case of a medical emergency and ensures immunity from liability for authorized personnel.
   
   
2. POLICY
   It is Weber School District’s policy to allow medication to be administered at school under certain conditions. Personnel and students may store, carry, and/or administer medication in accordance with the procedures set forth in this policy. School personnel will not honor Do Not Resuscitate Orders at school or school activities.
   
   
3. DEFINITIONS
   1. “Prescription medication” means a pharmaceutical drug that legally requires a medical prescription to be dispensed.
   2. “Over-the-counter medication” means any medication that can be purchased without a prescription from a licensed medical provider. This includes alternative, herbal, or homeopathic substances.  
   3. “School personnel” means any person, 18 years or older, who is employed by Weber School District and assigned to a school in the district.
   4. “School sponsored activity” means an activity, field trip, class, program, camp, or clinic that is sponsored by Weber School District
   5. “Seizure rescue medication” means a medication, prescribed by a prescribing health care professional, to be administered as described in a student's seizure rescue authorization, while the student experiences seizure activity.
   6. “Adrenal crisis rescue medication” means a medication that a prescribing health care professional prescribes for administration to a student during an adrenal crisis activity.
      
      
4. ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNEL
   1. All arrangements for school personnel to administer medication at school are to be made only with the school nurse, or designated personnel. All School Medication Authorization forms provided to the school will be reviewed and approved by the registered school nurse prior to administering the medication.
   2. In addition to the specific procedures for certain medications set forth in the Procedures attached to this policy, prescription and/or over-the-counter medication may be administered to a student by school personnel only if:
      1. The student’s parent or legal guardian has provided a completed, current, signed, and dated “School Medication Authorization” form [http://wsd.net/docman-list/documents/nursing-1/health-care-plans/medications/611-medication-administration-authorization-form/file] providing for the administration of medication to the student during regular school hours (This request must be updated at the beginning of each school year (within the 1st ten school days) and whenever a change is made in the administration of medication); AND
      2. The student’s licensed medical provider has also signed and dated the “School Medication Authorization” form stating the name, method of administration, dosage, and time to be given, the side effects that may be seen in the school setting from the medication, and a statement that administration of medication by school personnel during the school day is medically necessary; AND
      3. The medication is delivered to the school by the student’s parent/guardian, or authorized adult. A one week’s supply or more is recommended; AND
      4. The medication is in its original container, clearly labeled with the student’s name and dose. Prescription medication must be properly labeled by a pharmacy. Medication improperly labeled on the container cannot be accepted and/or administered to the student. 
   3. The side effects of a medication shall determine if the drug is appropriate to delegate its administration to school personnel.  Any medication with known, frequent side effects that can be life threatening shall not be delegated.  Medications that require the student’s heart rate, blood pressure, or oxygen saturation to be obtained before, during, or after administration of the drug shall not be administered by school personnel. The school nurse will determine if a medication is appropriate to delegate.
   4. Narcotic pain medication may not be brought to school, kept at school, nor administered by school personnel. 
   5. All medications (both prescription and over-the-counter) specified in a student’s IEP, Health Care Plan, or 504 accommodation plan will be administered as outlined in the relevant plan.
   6. Administration of medication by school personnel may be discontinued by the school at the school’s discretion any time after notification to the parent/guardian.
      1. Discontinuation of administration of medication by school personnel is appropriate under either of the following circumstances:
         1. The parent/guardian has been non-compliant with this policy; or
         2. The student has been non-compliant with this policy by refusing medication repeatedly or continued resistance to respond to school personnel for administration of medication at the appointed time.
         3. If a student has a 504 or an IEP, the school’s determination to discontinue administration of medication for the above reasons may only occur after meeting with the student’s parent/legal guardian.
   7. School personnel will not be required to administer medical cannabis or any derivative thereof, or CBD oil, lotion, or other form of CBD product, to students at school.  Students who wish to bring and self-administer CBD products containing zero amounts of THC to school must allow school personnel to store the CBD product in a locked health medication drawer. 
      
      
5. STUDENT SELF-ADMINISTRATION OF MEDICATION AT SCHOOL 
   1. If a student’s parents and medical provider sign and return the appropriate individualized health care plan, and if applicable, associated medical orders, any student with the requisite maturity and competency, as determined by the health plan team or 504 team, may possess and self-administer the following:
      1. inhalers
      2. epinephrine auto-injectors
      3. diabetes medication
   2. Except for what is provided in Section (V)(A), students in grades kindergarten through grade 6 may not possess or self-administer any other medications. Students needing medications described in Sections (V)(A)(1) through (3) must have an individualized health care plan.
   3. In addition to Section (V)(A), students in grades 7 through 12 may possess and self-administer medication under the following circumstances:
      1. The student may only carry one day’s dosage of medication, excluding narcotics; and
      2. The student has the requisite maturity and competency as determined by the health plan team or 504 team; and
      3. For Sections (V)(A)(1) through (3), a student must also have an individualized health care plan. 
   4. Students who possess medication not prescribed, or medication not properly labeled, or in Elementary school, medication not listed in Sections (V)(A)(1) through (3) may be subject to discipline according to Policy 5200.
      
      
6. SCHOOL RESPONSIBILITIES
   1. Each school in Weber School District will comply with the following obligations under this policy regarding administration of medication to students at school:
      1. Annually send a notice to the parents/guardians regarding medication administration in the school.
      2. Designate school personnel (“Designated School Personnel”) to administer medication and notify the school nurse of medication needs. 
      3. Arrange annual training with the school nurse and designated school personnel.  Designated school personnel, including teachers in charge of field trips, will sign that they received medication administration training. This training will include:
         1. How to properly administer medication(s).
         2. Indications for the medication(s).
         3. Dosage and time of medication(s).
         4. Adverse reactions and side effects of medication(s).
         5. Proper maintenance of records.
      4. Maintain records regarding administration of medication.
         1. Each student must have their own file which includes a “School Medication Authorization” and the “Daily Medication Recording Form.” [can be found under the Medication Heading at http://wsd.net/departments/support/nursing/health-care-plans ] Daily medication administration may also be recorded on the student’s electronic school record in lieu of using the paper form.
         2. The “Daily Medication Recording Form” or electronic school record documents the following: 
            1. which Designated School Personnel administered the medication;
            2. the dosage, time of day, and the date; 
            3. when and how much medication was delivered to the school by the parent/legal guardian on the “Medication Check-in/Disposal” form [http://wsd.net/docman-list/documents/nursing-1/health-care-plans/medications/612-medication-check-in-disposal-form/file]; and
            4. how much medication was discarded (if necessary) and who witnessed the disposal.  Disposal of medication requires the presence of two people to record the amount of medication discarded, the date, and how it was discarded.
            5. Each day will be filled in or designated as a non-school day. 
         3. The “Daily Medication Recording Form” will be available to parents/legal guardians upon request.
         4. All medication documents will be placed in an appropriate file at the end of each year.
      5. Provide a secure location for the safekeeping of medications, per the following:
         1. Medication to be administered by the designated school personnel must be stored in a locked cabinet or secure refrigerated unit.
         2. Adequate temperature of all medication must be maintained;
         3. Unused medication(s) should be picked up within two weeks following notification of parents/guardians, or it will be disposed of by the school and recorded on the “Medication Check-in/Disposal Form.” 
   2. Designated School Personnel are responsible to administer medication to all students with a School Medication Authorization form signed by parents/legal guardians and physicians.  If a medication is repeatedly refused, a school official will notify the parent/guardian.
   3. Any adverse reactions or medication errors will be reported promptly to the parent/guardian. If the parent is unavailable, the student’s doctor will be called for further direction.  This adverse reaction or medication error must be documented on the “Medication Error/Adverse Reaction Reporting Form.” [http://wsd.net/docman-list/documents/nursing-1/health-care-plans/medications/609-medication-error-adverse-reaction-form/file].
   4. School personnel who provide or receive training to store and administer medication under this policy and who act in good faith are not liable in any civil or criminal action for any act taken under this policy¹.
      
      
7. MEDICATIONS
   1. The District will follow the attached procedures and protocol for the administration of epinephrine, stock albuterol, glucagon, seizure rescue medication, nasal naloxone, and adrenal crisis rescue medication at school.
      
      
8. DO NOT RESUSCITATE DIRECTIVES
   1. Life-sustaining emergency care (First Aid, CPR, calling 911, etc.) will not be denied to any student in need of such care, regardless of race, color, sex, religion, age, natural origin, disabilities, or the existence of a medical directive.
   2. “Do Not Resuscitate” orders (DNR Order) will not be honored by school personnel of the school district. Such medical decisions will be left to those medical professionals who are licensed to make these decisions.
   3. A school that receives a DNR Order from a parent or legal guardian, or an adult student, shall maintain the Order in the student’s individualized health plan, but a DNR Order will not be honored by school personnel.
   4. School personnel providing life-sustaining emergency care will immediately inform the emergency medical services personnel responding to the emergency if a student has a DNR Order
      
      
9. PROCEDURES FOR ADMINISTRATION OF SPECIFIC MEDICATIONS
   1. Epinephrine and Albuterol
      1. Storage.
         1. A school may obtain a prescription for a supply of epinephrine and may store them at the school for emergency use in severe allergic or anaphylactic reactions.
         2. Emergency epinephrine and antihistamines, or inhalers with albuterol provided by the family of a known allergic or asthmatic student will also be kept at the school if the proper individualized health care plan has been submitted by the parent annually.
         3. The epinephrine and stock albuterol will be stored in an area that can be readily accessible to school personnel who may have occasion to use it in an emergency, but not accessible to students.
      2. Training
         1. All secretaries, office aides, paraprofessionals, and all CPR-certified staff are considered Designated School Personnel and will be trained to administer epinephrine and/or stock albuterol. 
         2. Training for storage and emergency use of epinephrine shall be provided by the school nurse, or other person qualified to provide such training.  Training for the storage and emergency use of stock albuterol shall be provided by the Department of Health. The school nurse will provide this training to the Designated School Personnel.
         3. Training will include:
            1. recognition of symptoms of anaphylaxis and/or an asthma emergency;
            2. standards and procedures for the storage and emergency use of epinephrine and/or stock albuterol;
            3. emergency follow-up procedures, including calling the emergency 911 number and contacting, if possible, the student's parent and physician; and
            4. written materials covering this information, which shall be retained for reference by the Designated School Personnel.
      3. Administration
         1. Designated School Personnel will immediately administer epinephrine or stock albuterol to a student exhibiting potentially life-threatening symptoms of anaphylaxis or asthma.
         2. Emergency personnel (911) must be called any time epinephrine is administered by Trained School Personnel.  Designated School Personnel shall initiate other appropriate follow-up in accordance with the training described above in Section (VI)(A)(3), after administering epinephrine.
         3. Students may carry and self-administer epinephrine and/or inhalers with albuterol if the parents and medical providers sign and return the individualized health care plan.
   2. Glucagon
      1. A student or school may possess or store prescribed glucagon so it will be available for administration in an emergency in accordance with this policy. 
      2. A parent of a student with diabetes who has been prescribed glucagon may submit a glucagon authorization, included in the  Diabetes Medical Management Plan, Section 12, Provider Orders[https://intermountainhealthcare.org/locations/primary-childrens-hospital/medical-services/diabetes/], requesting the student’s school to identify and train school personnel who volunteer to be trained in the administration of glucagon in accordance with this policy. 
      3. Training
         1. Upon receiving a glucagon authorization (DMMP), the school will, within a reasonable time after receiving the DMMP, train two or more school personnel who volunteer to be trained in the administration of glucagon (“Glucagon Trained School Personnel”).
         2. Training in the administration of glucagon will be provided by the school nurse or other qualified, licensed medical professional.
         3. Training will include:
            1. techniques for recognizing the symptoms that warrant the administration of glucagon; and
            2. standards and procedures for the storage and use of glucagon; and
            3. other emergency procedures, including calling 911 number and contacting, if possible, the student’s parents; and
            4. written materials covering the information required under this Section, which shall be retained for reference by the Glucagon Trained School Personnel.
      4. Administration
         1. Glucagon Trained School Personnel may administer glucagon at a school or school-sponsored activity to a student with a DMMP if the student is exhibiting symptoms that warrant the administration of glucagon; and a licensed healthcare professional is not immediately available.
         2. Glucagon Trained School Personnel shall direct a responsible person to call 911 and take other appropriate actions in accordance with the training materials provided during the training.
   3. Seizure Rescue Medications
      1. A parent of a student who experiences seizures may submit a Seizure Medication Management Order (SMMO) [https://choosehealth.utah.gov/documents/pdfs/school-nurses/Seizure%20Forms/smmo_ada_12-27-18_fillable.pdf] to the school under the following circumstances:
         1. The SMMO includes the following:
            1. Certification that:
               1. a prescribing health care professional has prescribed a seizure rescue medication for the student;
               2. the student’s parent has previously administered the student’s seizure rescue medication in a non-medically supervised setting without a complication; and
               3. the student has previously ceased having full-body prolonged or convulsive seizure activity as a result of receiving the seizure rescue medication.
            2. A description of the specific seizure rescue medication authorized for the student including the indicated dose, and instructions for administration;
            3. A request that the student’s school identify and train school employees who are willing to volunteer to receive training to administer a seizure rescue medication in accordance with this Policy (“Seizure Rescue Trained Personnel); and
            4. Authorization for a trained school employee volunteer to administer a seizure rescue medication in accordance with this Policy.
      2. Upon receipt of an SMMO, the school will:
         1. inform school employees of the opportunity to be a Seizure Rescue Trained Personnel;
         2. provide training to each school employee who volunteers to be a Seizure Rescue Trained Personnel.
      3. A school may not prohibit or compel a school employee from becoming a Seizure Rescue Trained Personnel.
      4. Training
         1. A Seizure Rescue Trained Personnel must:
            1. be an employee of a school where at least one student has an SMMO 
            2. be at least 18 years old;
            3. volunteer to receive training in the administration of seizure rescue medication;
            4. complete a training program described below;
            5. demonstrate competency on an assessment following training; and
            6. complete annual refresher training each year that the individual intends to remain a Seizure Rescue Trained Personnel.
         2. Training shall be provided by the school nurse or a licensed healthcare professional and shall follow the training program developed by the Department of Health pursuant to Utah Code §53E-9-505.
         3. Training shall include:
            1. techniques to recognize symptoms that warrant the administration of a seizure rescue medication;
            2. standards and procedures for the storage of a seizure rescue medication;
            3. other emergency procedures, including calling 911 and contacting the student's parent, if necessary;
            4. an assessment to determine if an individual is competent to administer a seizure rescue medication;
            5. an annual refresher training component; and
            6. written materials describing the information provided in the training, which will be retained for reference by the school.
   4. Naloxone (Nasal Narcan)
      1. Administration
         1. School personnel will provide assistance to any person(s) who may be suffering from an opioid overdose.
         2. Trained school personnel shall make every reasonable effort to include the use of naloxone combined with CPR, to revive the victim of any apparent drug overdose. 
      2. Training
         1. School staff who are CPR certified will be trained annually, or as needed, to properly administer naloxone.
         2. The training will be provided by the school nurse.
         3. The training will include:
            1. Recognizing the signs and symptoms of an opioid overdose
            2. Standards and procedures, including calling 911, when administering naloxone
            3. How to properly administer naloxone to reverse the symptoms
      3. Medication supply and storage
         1. The school will fund supplies of naloxone through a participating pharmacy.
         2. The supervising physician for Weber School District, will be the authorized prescriber to obtain naloxone and will write prescriptions as needed to replace medications.
         3. Naloxone has an expiration date of about 12-18 months from the date of manufacture. The school nurse will be responsible for checking the expiration date of the product and will notify the District Nursing Supervisor when the medication is expiring.
         4. Naloxone will be stored in an area out of reach of the student body, but accessible to staff when needed.
         5. Naloxone will be available for all students, staff, or visitors who are on school grounds during school hours.
   5. Adrenal Crisis Rescue Medication
      1. A student or school may possess or store prescribed adrenal crisis rescue medication so it will be available for administration in an emergency in accordance with this policy.
      2. A parent of a student who experiences Adrenal Insufficiency may submit an Adrenal Insufficiency Crisis Rescue Authorization to the school requesting the student’s school to identify and train school personnel who volunteer to be trained in the administration of adrenal crisis rescue medication in accordance with this policy.
      3. Upon receipt of an Adrenal Insufficiency Crisis Rescue Authorization, the school will:
         1. Inform school employees of the opportunity to be an Adrenal Crisis Medication Trained Personnel;
         2. Provide training to each school employee who volunteers to be an Adrenal Crisis Medication Trained personnel.
      4. A school may not prohibit or compel a school employee from becoming Adrenal Crisis Medication Trained Personnel.
      5. Training
         1. An Adrenal Crisis Medication Trained Personnel must:
            1. be an employee of a school where at least one student has an adrenal crisis rescue authorization,
            2. be at least 18 years old;
            3. volunteer to receive training in the administration of adrenal crisis  rescue medication;
            4. complete a training program described below;
            5. demonstrates competency to administer an adrenal crisis rescue medication through an assessment; and
            6. complete annual refresher training each year that the individual intends to remain an Adrenal Crisis Medication trained personnel. 
         2. The training will be provided by the school nurse.
         3. The training will include:
            1. techniques for recognizing the symptoms that warrant the administration of adrenal crisis rescue medication; and
            2. standards and procedures for the storage and use of adrenal crisis rescue medication; and
            3. other emergency procedures, including calling 911 number and contacting, if possible, the student’s parents; and
            4. written materials covering the information required under this Section, which shall be retained for reference by the Adrenal Crisis Medication trained personnel.

¹ Refer to Utah Code Ann. §53G-9-502(3).

Approved by the Board 10/02/2024