Adopted by the State Board 3-14-06
Document #8583, Effective 3-15-06
PART Ed 311 SCHOOL HEALTH SERVICES
Section Ed 311.01 School Immunization Program
Section Ed 311.03 Physical Examination of Students
Document # 9158, Effective 5-16-08
Section Ed 311.02 Medication During School Day
Ed 311.01 School Immunization Program.
(a) A parent or legal guardian shall have a child immunized against certain diseases as determined in rules He-P 301.14, Immunization Requirements, adopted by the commissioner of the department of health and human services.
(b) A child shall be exempt from immunization in accordance with RSA 141-C:20-c.
(c) A child who is exempt from immunization in accordance with (b) shall not attend school during an outbreak of a communicable disease for which immunization is required under RSA 141-C:20-a.
(d) If a child is not immunized as in Ed 311.01(a), does not have a religious or medical exemption, or is unable to provide evidence of acceptable immunization for conditional enrollment, he/she shall not be admitted to school.
Ed 311.02 Medication During School Day.
(a) For the purpose of this rule "school day" means any time during the day, afternoon, or evening when a child is attending school or other school related activity.
(b) Any pupil, who is required to take during the school day a medication prescribed by a licensed physician, advanced registered nurse practitioner, licensed physician's assistant or dentist, shall have a school nurse either assist the student to take the medication or administer the medication.
(c) This duty may also be undertaken by a RN or LPN under the direction of the school nurse.
(d) The school nurse may delegate the administration of medications, if appropriate to others pursuant to RSA 326-B Nurse Practice Act and Nur 404.
(e) Asthma inhalers and epinephrine auto injectors may be possessed by a student and self-administered in accordance with RSA 200:42 through RSA 200:47.
(f) If the school nurse is not available the building principal or designee is permitted to assist students in taking required medications by:
(1) Making such medications available to the student as needed; and
(2) Observing the student as he/she takes or does not take his/her medication; and
(3) Recording whether the student did or did not take his/her medication.
(g) Upon receiving a request from the parent, guardian, or physician relative to a particular student's need for medication during school hours, the school nurse may contact the parent, or guardian to discuss whether the student should remain at home, or whether the medication should be taken before, during, and/or after school. The nurse may also inquire about any other medical conditions requiring medications and any special side effects, contraindications and adverse reactions to be observed.
(h) Each local school board, with the advice of the school nurse(s) and school physician if available shall establish specific policy and procedures to give protection and controls to the matter of medications in schools.
(i) In order for prescription medications to be given at the school, the following shall occur:
(1) The school nurse shall ensure that a written statement from the licensed prescriber containing the following be in the student's health record:
a. The student's name;
b. The name and signature of the licensed prescriber and contact numbers;
c. The name, route and dosage of medication;
d. The frequency and time of medication administration or assistance;
e. The date of the order; and
f. A diagnosis, if not a violation of confidentiality;
(2) The school nurse shall ensure that there is written authorization by the parent and/or guardian which contains:
a. The parent and/or guardian's printed name and signature;
b. A list of all medications the student is currently receiving, if not a violation of confidentiality or contrary to the request of the parent, guardian or student that such medication be documented; and
c. Approval to have the school nurse or designee administer the medication, the student to possess and self-administer and/or the principal or his designee assist the student with taking the medication; and
(3) The school nurse shall ensure the authorization or other accessible documentation contains:
a. The parent and/or guardian's home and emergency telephone number(s); and
b. The names of persons to be notified in case of a medication emergency in addition to the parent or guardian and licensed prescriber.
(j) The school nurse shall develop a system of documenting and communicating significant observations relating to prescriptions, medication's adverse reactions, and other harmful effects, to the child's parent or guardian and/or licensed prescriber.
(k) The school nurse shall develop and implement procedures regarding receipt and safe storage of prescription medications.
(l) A parent, guardian or a parent/guardian-designated, responsible adult shall deliver all medication to be administered by school personnel to the school nurse or other responsible person designated by the school nurse as follows:
(1) The prescription medication shall be in a pharmacy or manufacturer labeled container;
(2) The school nurse or other responsible person receiving the prescription medication shall document the quantity of the prescription medication delivered; and
(3) The medication may be delivered by other adult(s), provided, that the nurse is notified in advance by the parent or guardian of the delivery and the quantity of prescription medication being delivered to school is specified.
(m) All medications shall be stored in their original pharmacy or manufacturer labeled containers and in such manner as to render them safe and prevent loss of efficacy. A single dose of medication may be transferred from this container to a newly labeled container for the purposes of field trips or school sponsored activities.
(n) All medication to be administered by the school nurse shall be kept in a securely-locked cabinet which is kept locked except when opened to obtain medications. Medications requiring refrigeration shall be stored in a locked box in a refrigerator maintained at temperatures of 38 degrees to 42 degrees. Emergency medications may be secured in other locations readily accessible only to those with authorization.
(o) No more than a 30-school day supply of the prescription for a student shall be stored at the school.
(p) Non-prescription medication shall be given only with the written authorization of the parent and/or guardian and if this is in accordance with school policy.
Ed 311.03 Physical Examination of Students. Schools shall accept documentation of a student's physical examination, provided:
(a) The examination has been performed within the past year; or
(b) If an examination has not been performed within the past year, the school shall accept documentation of an appointment for a physical examination with a licensed physician, advanced registered nurse practitioner or physician's assistant within a time determined by the school district for conditional enrollment.