Adopted: January 1979
Revised: October 2024
Download 506.2.2AR - Administration of Medication and Access to Telehealth Services
1. Prescription Medication
1.1 Students requiring the administration of prescription medication at school shall provide the school with written authorization from their parent or guardian using Procedure 506.2.2.1P, Authorization for Administration of Medication at School. If the medication is to be given for more than two weeks or is a narcotic pain medication, a written order from a authorized health care provider or dentist must be provided to the school using Procedure 506.2.2.1P, Authorization for Administration of Medication at School, or other appropriate documentation.
1.2 Prescription medication shall be brought to the school nurse, preferably by the parent or guardian, in a container appropriately labeled by a pharmacist and must be administered in a manner consistent with the instructions on the label. Prescription medication shall be kept in the health office, with the exception of medications (such as some seizure medications) which must be kept near the student in order to be administered in accordance with authorized health care provider’s order received by the school nurse, as well as inhalers, Epinephrine auto- injector pens (EpiPens) and/or insulin authorized by the student’s parent or guardian (see section 1.2.2 below). For drugs or medicine used by children with a disability, administration may be as provided in the IEP, Section 504 plan or IHP.
1.2.1 If the medication includes a controlled substance, the parent or guardian must give the school nurse written, signed information on the exact amount of medication that is being given to the student.
1.2.1.1 The district has the right to ask parents to leave no more than a 30-day supply of any controlled substance with the school nurse.
1.2.2 Students may carry inhalers, EpiPens, insulin and other approved emergency medications with them during the school day once the school nurse receives either Procedure 506.2.2.1.2.2P, Authorization for Student Possession and Self-Medication with Inhaler, EpiPen, Insulin, and/or Other Emergency Medication at School, and/or an Anaphylaxis Action Plan and/or other health or 504 plan with the appropriate documentation.
1.2.3 The school must be notified immediately by the parent or student 18 years old or older in writing of any change in the student’s prescription medication administration. A new medical authorization and container label with new pharmacy instructions shall be required immediately as well.
1.3 Prescription medication shall be administered by the school nurse or, in his or her absence, other appropriate school personnel as designated by the principal and delegated by the school nurse. Personnel shall not reassign tasks delegated to them by the school nurse.
1.3.1 With the exception of EpiPens or medications the student is authorized to self-administer, medication that is not taken orally may only be administered by a licensed school nurse (LSN), or a registered nurse (RN) or a licensed practical nurse (LPN) under the direction of a LSN or by other appropriate school personnel following proper delegation by the school nurse.
1.3.2 School nurses shall not administer allergy shots.
1.4 Students observed administering prescription medication (other than per section 1.2.2 above) to themselves shall be reported to their parent or guardian by the school nurse or other appropriate personnel, and disciplinary measures will be taken as described in Administrative Regulation 503.3AR, Student Behavior Expectations and Consequences for Misbehavior.
1.5 Prescription medications that are no longer needed at school will generally be returned to parents or guardians rather than sending the medication home with a student. Exceptions include students who keep their medication with them per paragraph 1.2, and circumstances in which it is impractical to return a medication directly to a parent or guardian. If medication remains in the health office after the end of a school year or when a student is no longer attending the school or after the medication is discontinued, the school nurse will contact the student’s parent or guardian to let them know that they have one month to pick up the medication; if the medication is not picked up, it will be destroyed. Exceptions may be approved by the Health Services Coordinator. The transportation of unclaimed or abandoned prescription drugs or medications will occur at least annually. If the unclaimed or abandoned prescription drug is not a controlled substance as defined by Minnesota Statute 152.01, subd. 4, or is an over-the-counter medication, the school nurse shall be responsible for transporting the drug or medication to a designated drop-off box or collection site or may request that a law enforcement agency transport the drug or medication to a drop-off box or collection site on behalf of the school district. If the unclaimed or abandoned prescription drug is a controlled substance as defined by Minnesota Statute 152.01, subd. 4, school personnel are prohibited from transporting the prescription drug to a drop-off box or collection site for prescription drugs. The school will request that a law enforcement agency transport the prescription drug or medication to a collection bin that complies with Drug Enforcement Agency regulations, or if a site is not available, under the agency's procedure for transporting drugs.
1.6 Prescription medication as used in this regulation does not include any form of medical cannabis as defined in Minnesota Statutes, section 152.22, subdivision 6.
1.7 School personnel will collaborate with the parent or guardian to implement a seizure action plan when an enrolled student’s parent or guardian has notified the school that the student has a diagnosed seizure disorder and has seizure rescue medication or medication prescribed by the student’s authorized health care provider to treat seizure disorder symptoms approved by the United States Food and Drug Administration. The seizure action plan will conform with requirements in section 3.1 of administrative regulation 506.2.1AR, Student, Community Education Participant or Visitor Medical Emergencies.
2. Non-Prescription Medication
2.1 Subject to the flexibility provided in section 2.2, a specific non-prescription medication may only be given to the student if the school has received written authorization from the student's parent or guardian to give that particular medication to their child, and if the medication is provided to the school nurse in its original container. Authorization may be provided using Procedure 506.2.2.1P, Authorization for Administration of Medication at School. In most cases, district nurses will only administer medications approved by the Food and Drug Administration (FDA) in age-appropriate dosages. The school nurse shall use his or her professional judgment in consultation with the Health Services Coordinator to determine the need for non-FDA approved non-prescription drugs.
2.2 A student in grades 7-12 may possess and use nonprescription pain relief in a manner consistent with the labeling, if the school has received written annual authorization from the student’s parent or guardian permitting the student to self-administer the medication. The school may revoke the student’s privilege to possess and use non-prescription pain relief if it is determined that the student is abusing the privilege. This section does not apply to the possession or use of any drugs or product containing ephedrine or pseudoephedrine as an active ingredient.
2.2.1 When giving permission for a student in grades 7-12 to possess and use nonprescription pain relief, the parent or guardian agrees to the following:
2.2.1.1 The medication must be in its original container;
2.2.1.2 The student is knowledgeable in the proper dosage, use and administration of the medication in a manner consistent with its labeling;
2.2.1.3 If school administration determines these rules have been abused, the school may revoke this privilege;
2.2.1.4 The student may not possess pain relievers containing ephedrine or pseudoephedrine, and
2.2.1.5 The student cannot share the medication with other students.
2.3 The return of non-prescription medications kept in the health office will be handled in a manner similar to the return of prescription medications pursuant to section 1.5.
3. Medication Schedule – If it is not essential for medication to be given during school hours, school personnel shall work with the parent or guardian and health provider to adjust dosage so it can be administered outside of school hours.
4. Record-keeping – Administration of each dose of medication, other than self- administered medication by the student, shall be recorded electronically each day in the district student information system.
5. Clinical Trials – A district nurse may administer research medication to a student who is actively participating in an approved and registered clinical trial and who requires a dose of the medication during the school day. Requests to administer research medication as part of a clinical trial will be evaluated on a case-by-case basis by the school nurse in consultation with the district’s Health Services Coordinator. The district and nurse may exercise their judgment to decline to administer the medication in circumstances in which the safety risk is determined to be too great or the burden on nursing staff too significant. The following materials are required before the administration of medication as part of a clinical trial may occur:
5.1 The protocol or a study summary from the research organization conducting the clinical trial, including a written order for the medication from the research organization and the signs and symptoms of potential adverse reactions;
5.2 the detailed informed consent form signed by the parents/guardians for the clinical trial;
5.3 signed parental permission authorizing the administration of the medication at school;
5.4 any applicable reporting or follow-up requirements required of the school nurse, and
5.5 the name(s) and telephone number(s) of the investigator or research team conducting the clinical trial.
6. Opioid Antagonists
6.1 The district will keep at least two doses of nasal naloxone, an opioid antagonist medication, in each district school. The opioid antagonist medications will be authorized by a current standing order/condition specific protocol from the district’s licensed physician.
6.2 For purposes of this section, a standing order/protocol means directions from the school district’s physician that sets forth how to house and administer opioid antagonist medications to students, staff members or other individuals believed or suspected to be experiencing an opioid overdose. The standing order/protocol should include the administration type, dosage, date of issuance and signature of the district’s physician. The standing order/protocol shall incorporate the district’s steps for the administration of opioid antagonist medications. The district’s Health Services Coordinator will obtain and maintain the standing order/protocol and will update and renew the standing order/protocol annually or as otherwise required.
6.3 If authorized, stock opioid antagonist medications must be clearly labeled, monitored for expiration dates and stored in the health office or other location determined by the school nurse in consultation with the Health Services Coordinator and building principal and accessible to staff in the event of a suspected overdose.
6.4 Opioid antagonist medications may be administered by a trained, licensed school nurse or other trained staff person in an emergency when an opioid overdose is suspected in a student, staff member or visitor. Nurses are responsible for attending all required trainings pertaining to this regulation and the protocol for the storage and use of opioid antagonist medications and shall perform any assigned responsibilities under the regulation and protocol. All staff members who may be responsible for administering an opioid antagonist will be trained as described in section 6.5 of this regulation.
6.5 Before stocking opioid antagonist medications, the nurse and other relevant staff members must be trained in the recognition of the signs of opiate overdose, the use of opiate antagonist medications as part of the emergency response to opiate overdose and the district’s protocol for the administration of opioid antagonist medications. The district’s Health Services Coordinator shall determine the type and method of training and coordinate the implementation of training.
6.6 In the event that an opioid antagonist medication is administered, 911 will be called to respond to the emergency even if the recipient appears to be recovered. If the recipient of the opioid antagonist medication is believed to be a minor or a student of any age, school staff will attempt to identify and contact the parent or guardian and inform them of the circumstances and actions taken. The acting school administrator and Health Services Coordinator will be informed as soon as possible following the administration of an opioid antagonist medication and any additional emergency steps.
6.7 The school district will maintain the privacy of students and staff related to the administration of opioid antagonist medications as required by law.
6.8 Nothing in this section shall be interpreted to preclude, alter or infringe upon the application of Minnesota Statute 604A.04, Good Samaritan Overdose Prevention.
7. Access To Space For Mental Health Care Through Telehealth
7.1. Beginning October 1, 2024, to the extent space is available, the school district must provide an enrolled secondary school student to space at the school site that a student may use to receive mental health care through telehealth from a student's licensed mental health provider. Access must be provided during regular school hours, and, to the extent staff is available, before or after the school day on days when students receive instruction at school. Secondary schools must develop a plan with procedures to receive requests for access to the space.
7.2 The space provided under paragraph 7.1 must provide a student privacy to receive mental health care.
7.3 A student may use a school-issued device to receive mental health care through telehealth.
7.4 A school may require a student requesting access to space under this section to submit to the school a signed and dated consent from the student's parent or guardian, or from the student if the student is age 16 or older, authorizing the student's licensed mental health provider to release information from the student's health record that is requested by the school to confirm the student is currently receiving mental health care from the provider. Such a consent is valid for the school year in which it is submitted.
8. Epinephrine Auto-Injectors
8.1 The district and individual schools may obtain and possess epinephrine auto-injectors to be maintained and administered by school personnel, including a licensed nurse, to a student or other individual if, in good faith, it is determined that person is experiencing anaphylaxis regardless of whether the student or other individual has a prescription for an epinephrine auto-injector. The administration of an epinephrine auto-injector in accordance with Minnesota Statutes, section 121A.2207 is not the practice of medicine.
8.2 Registered nurses may administer epinephrine auto-injectors in a school setting according to a condition-specific protocol as authorized under Minnesota Statutes, section 148.235, subdivision 8. Notwithstanding any limitation in Minnesota Statutes, sections 148.171 to 148.285, licensed practical nurses may administer epinephrine auto-injectors in a school setting according to a condition-specific protocol that does not reference a specific patient and that specifies the circumstances under which the epinephrine auto-injector is to be administered, when caring for a patient whose condition falls within the protocol.
8.3 A district or school may enter into arrangements with manufacturers of epinephrine auto-injectors to obtain epinephrine auto-injectors at fair-market, free, or reduced prices. A third party, other than a manufacturer or supplier, may pay for a school’s supply of epinephrine auto-injectors.
9. Sunscreen - A student may possess and apply a topical sunscreen product during the school day while on school property or at a school-sponsored event without a prescription, physician’s note, or other documentation from a licensed health care professional. School personnel are not required to provide sunscreen or assist students in applying sunscreen.
References:
- Minnesota Statute 121A.21, School Health Services
- Minnesota Statute 121A.216 Access to Space for Mental Health Care through Telehealth
- Minnesota Statute 121A.22, Administration of Drugs and Medicine
- Minnesota Statute121A.2205, Possession and Use of Epinephrine Auto- Injectors; Model Policy
- Minnesota Statute 121A.2207, Life Threatening Allergies in Schools; Stock Supply of Epinephrine Auto-Injectors
- Minnesota Statute 121A.221, Possession and Use of Asthma Inhalers by Asthmatic Students
- Minnesota Statute 121A.222, Possession and use of nonprescription pain relievers by secondary students
- Minnesota Statute 121A.223 Possession and Use of Sunscreen- Minnesota Statute 148.171 Definitions; Title
- Minnesota Statute 144.344 Emergency Treatment
- Minnesota Statute 151.37 Legend Drugs; Who May Prescribe, Possess
- Minnesota Statute 151.37, Legend Drugs; Who May Prescribe, Possess- Minnesota Statute 152.212 Labeling of Prescription Drug Containers
- Minnesota Statute 152.01 Definitions
- Minnesota Statute 152.02 Schedules of Controlled Substances- Minnesota Statute 152.22 Definitions
- Minnesota Statute 152.23, Limitations
- Minnesota Statute 604A.04, Good Samaritan Overdose Prevention
- Minn. Stat. § 604A.05 Good Samaritan Overdose Medical Assistance
- Minn. R. Pt. 6800.4220 Schedule II Controlled Substances
- Minn. R. Pt 8710.6100 School Nurse- MSBA/MASA Model Policy 516