JHCD/JHCDA - Medications**
Policy JHCD
Code: JHCD/JHCDA
Readopted: 8/30/2021
Adopted: 2/11/25
Orig. Code(s): JHCD/JHCDA
The district recognizes administering a medication to a student and/or permitting a student to administer a medication to themselves may be necessary to allow the student to attend school. Therefore, the district allows medication, including injectable medications, to be administered to a student by designated personnel and the administration of medication by a student to themselves without assistance from designated personnel, subject to criteria established by the district and in accordance with Oregon law.
The district shall designate personnel authorized to administer medications to students. Medications, including injectable medications, may be administered by designated district personnel as part of a formal training or delegation by a registered nurse. Training shall be provided to designated personnel in accordance with law. The training will include discussion of this policy, procedures and materials, including but not limited to, procedures outlined in administrative regulation JHCD-AR – Medications.
When a licensed nurse practicing in the school setting is not immediately available, trained personnel designated by the district may administer epinephrine, glucagon, treatment for adrenal insufficiency, or another medication to a student as prescribed and/or as otherwise allowed by Oregon law.
The district reserves the right to reject a request for administration of medication at school, either by district personnel or student self-administration, if the medication is not necessary for the student to remain in school.
The district may revoke permission given to a student to self-administer medication if the student does not responsibly self-administer the medication or abuses the use of the medication, as determined by district personnel.
Medications will be handled, stored, monitored, disposed of and records maintained in accordance with law and established district procedures governing the administration of prescription or nonprescription medications to students.
A premeasured dose of epinephrine may be administered by trained, designated personnel to any student or other individual on district premises who the person believes in good faith is experiencing a severe allergic reaction, regardless of whether the student or individual has a prescription for epinephrine.
A non-injectable short-acting opioid antagonist, if available, may be administered by any district personnel (whether or not they have received training on administering medications) to any student or other individual on district premises who the individual administering the short-acting opioid antagonist believes in good faith is experiencing an opioid overdose. A short-acting opioid antagonist may be administered to a student who experienced or is experiencing an opioid overdose without written permission and instructions of the student’s parents or guardian.
The superintendent shall develop administrative regulations to meet the requirements of law and the implementation of this policy.
END OF POLICY
Legal Reference(s):
ORS 332.107
ORS 339.866 - 339.871
ORS 433.800 - 433.830
ORS 689.800
OAR 166-400-0010(17)
OAR 166-400-0060(29)
OAR 333-055-0000 - 0035
OAR 581-021-0037
OAR 581-022-2220
OAR 851-047-0000 - 0030
Family Educational Rights and Privacy Act of 1974, 20 U.S.C. § 1232g (2018); Family Educational Rights and Privacy, 34 C.F.R. Part 99 (2019).
OREGON HEALTH AUTHORITY AND OREGON DEPARTMENT OF EDUCATION, Medication Administration: A Manual for School Personnel.
House Bill 1552 (2024).
JHCD - AR
Code: JHCD-AR
Adopted: 2/11/25
Students may, subject to the provisions of this administrative regulation, have prescription or nonprescription medication administered by designated district personnel, or may be permitted to administer prescription or nonprescription medication to themselves.
1. Definitions[1]
a. “Adrenal crisis” means a sudden, severe worsening of symptoms associated with adrenal insufficiency, such as severe pain in the lower back, abdomen or legs, vomiting, diarrhea, dehydration, low blood pressure or loss of consciousness. (ORS 433.800)
c. “Adrenal insufficiency” means a hormonal disorder that occurs when the adrenal glands do not produce enough adrenal hormones. (ORS 433.800)
d. “Asthma” means a chronic inflammatory disorder of the airways that requires ongoing medical intervention. (ORS 339.866)
e. “Delegation” means a formal delegation of a nursing procedure by a registered nurse to district personnel in accordance with the Oregon Nurse Practice Act. (OAR Chapter 851)
f. “Designated personnel” means the school personnel designated and trained to administer medication pursuant to district policy and procedure.
g. “Medication” means medication that is not injected; premeasured doses of epinephrine that are injected; medication that is available for treating adrenal insufficiency; and Naloxone or any similar medication that is in any form available for safe administration and that is designed to rapidly reverse an overdose of an opioid drug. “Medication” also means any prescription for bronchodilators or autoinjectable epinephrine prescribed by a student’s Oregon licensed health care professional for asthma or severe allergies. “Medication” does not include nonprescription sunscreen. (ORS 339.866; ORS 339.867)
h. “Nonprescription medication” means nonprescription drugs as defined in ORS 689.005, which means drugs that may be sold without prescription and that are prepackaged for use by the consumer and labeled in accordance with the requirements of the statutes and regulations of this state and the federal government. (OAR 581-021-0037)
i. “Notice of a diagnosis of adrenal insufficiency” means written notice to the district from the parent or guardian of a student who has been diagnosed as adrenal insufficient with a copy of an order from the student’s primary care provider that includes the student’s diagnosis, description of symptoms indicating the student is in crisis, prescription for medication to treat adrenal insufficiency crisis, and instructions for follow-up care after medication to treat adrenal insufficiency crisis has been administered. (OAR 581-021-0037)
j. “Opioid overdose” means a medical condition that causes depressed consciousness, depressed respiratory function or the impairment of vital bodily functions as a result of ingesting opioids. (ORS 689.800)
k. “Prescriber[2]“ means a “practitioner” as defined in ORS 689.005, which means a person licensed and operating within the scope of such license to prescribe, dispense, conduct research with respect to or administer drugs in the course of professional practice or research: (a) in this state; or (b) in another state or territory of the U.S. if the person does not reside in Oregon and is registered under the federal Controlled Substances Act. (OAR 581-021-0037)
l. “Prescription medication” means a “prescription drug” as defined in ORS 689.005, which means a drug that is: required by federal law, prior to being dispensed or delivered, to be labeled with “Caution: Federal law prohibited dispensing without prescription” or “Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian”; or required by any applicable federal or state law or regulation to be dispensed on prescription only or is restricted to use by practitioners only.
m. “Severe allergy” means a life-threatening hypersensitivity to a specific substance such as food, pollen, or dust. (ORS 339.866)
n. “Short-acting opioid antagonist” means any short-acting drug approved by the U.S. Food and Drug Administration for the complete or partial reversal of an opioid overdose. (ORS 689.800)
2. Designated Staff/Training
a. Medications, including injectable medications, may be administered by trained personnel as part of a formal training or delegation by a registered nurse.
b. The principal, in consultation with the district nurse, will designate district personnel authorized to administer prescription or nonprescription medication to a student which takes into account when the student is in school, at a district-sponsored activity, under the supervision of district personnel, or in transit to or from school-or district-sponsored activities, and may include when a student is in a before-school or after-school care program on school-owned property when required by law. The principal will supervise and ensure building and activity practices and procedures are consistent with the requirements of law, rules, policy and this administrative regulation.
c. The district will provide staff who are designated personnel to administer prescription or nonprescription medication access to a registered nurse practicing in a school setting.
d. The principal will ensure the annual non-injectable medication training required by Oregon law is provided to designated district personnel. Training must be conducted by a qualified trainer, which is a person who is familiar with the delivery of health services in a school setting and who is either a registered nurse licensed by the Oregon State Board of Nursing or a prescriber. The first training and every third training thereafter shall be provided in-person[3]. During subsequent years, designated district personnel may complete an online training so long as a trainer is available following the training to answer questions and provide clarification.
e. District personnel designated to administer epinephrine, glucagon, and medication to treat adrenal insufficiency shall be trained using related training developed by the Oregon Health Authority (OHA).
f. The training for district personnel will provide an overview of applicable provisions of Oregon law, administrative rules, district policy and administrative regulations and include, but not be limited to, discussion of the following: safe storage, administration, handling and disposing of medications; accessibility of medication during an emergency; record keeping; whether response to medication should be monitored by designated personnel and the role of designated personnel in such monitoring; emergency medical response procedures following administration of the medication; confidentiality of health information; and assessment of gained knowledge.
g. The district shall maintain documentation of district personnel’s completion of training in accordance with OAR 166-400-0010.
3. Administering Premeasured Doses of Epinephrine to a Student or Other Individual
A premeasured dose of epinephrine may be administered by trained district personnel to any student or other individual on district premises who the person believes in good faith is experiencing a severe allergic response, regardless of whether the student or individual has a prescription for epinephrine.
4. Administering Short-Acting Opioid Antagonists
A short-acting opioid antagonist may be administered by any district personnel[4] to any student or other individual on school premises who the individual administering the short-acting opioid antagonist believes in good faith is experiencing an overdose of an opioid drug.
The principal or designee shall immediately notify the parent or guardian of a minor student enrolled in a school within the district when a short-acting opioid antagonist is administered to the student while at school, on school property under the jurisdiction of the district or at any activity under the jurisdiction of the district.
The district shall provide to the parent or legal guardian of each minor student enrolled in a school in the district information regarding short-acting opioid antagonists. The information will include at least:
a. A description of short-acting opioid antagonists and their purpose;
b. A statement regarding, in an emergency situation, the risks of administering to an individual a short-acting opioid antagonist and the risks of not administering to an individual a short-acting opioid antagonist;
c. A statement identifying which schools in the district, if any, have short-acting opioid antagonists, and the necessary medical supplies to administer short-acting opioid antagonists, onsite and available for emergency situations; and
d. A statement that a representative of the district may administer a short-acting opioid antagonist to a student in an emergency if the student appears to be unconscious and experiencing an opioid overdose.
5. Administering of Medication to a Student Experiencing Symptoms of Adrenal Crisis
A student experiencing symptoms of adrenal crisis while the student is in school, at a district-sponsored activity, while under the supervision of school personnel, in a before-school or after-school care program on school-owned property and/or in transit to or from a school or a district-sponsored activity, may be treated by designated personnel and shall be subject to the following:
a. Upon notice of a diagnosis of adrenal insufficiency, as defined in Oregon Administrative Rule (OAR) 581-021-0037, the building principal of the school the student attends will designate one or more district personnel to receive training and be responsible for administering the medication to treat adrenal insufficiency to a student in the event the student exhibits symptoms the district personnel believe in good faith indicate the student is experiencing symptoms of adrenal crisis;
b. The designated personnel will successfully complete required training to administer medication to treat a student who has adrenal insufficiency and is experiencing symptoms of adrenal crisis;
c. The student’s parent or guardian must provide adequate supply of the student’s prescribed medication to the district;
d. The district will develop an individualized health care plan for the student;
e. In the event that a student experiences symptoms of adrenal crisis and the designated personnel determines the medication to treat adrenal insufficiency should be administered, any available district staff member will immediately call 911 and the student’s parent or guardian.
6. Administering Medication to a Student
a. A request to permit designated personnel to administer medication to a student may be approved by the district and is subject to the following:
(1) A written request for designated personnel to administer prescription medication to a student, if because of the prescribed frequency or schedule, the medication must be given while the student is in school, at a school-sponsored activity, while under the supervision of school personnel and in transit to or from school or a school-sponsored activity, must be submitted to the school office and shall include:
(a) The written permission of the student’s parent or guardian; and
(b) The written instruction from the prescriber for the administration of the medication to the student that includes:
(i) Name of the student;
(ii) Name of the medication;
(iii) Method of administration;
(iv) Dosage;
(v) Frequency of administration;
(vi) Other special instructions from the prescriber, if any; and
(vii) Signature of the prescriber.
(c) The prescription medication is provided in the original prescription packaging by the student’s parent or guardian. The prescription label prepared by a pharmacist at the direction of the prescriber, will be sufficient to meet this requirement if it contains the information listed in (i)-(vi) above.
(2) A written request for designated personnel to administer nonprescription medication to a student must be submitted to the school office and is subject to the following:
(a) The nonprescription medication is necessary for the student to remain in school
(b) The nonprescription medication is provided in the original manufacturer’s container by the student’s parent or guardian;
(c) The written instruction and permission from the student’s parent or guardian for the administration of the nonprescription medication[5] includes:
(i) Name of the student;
(ii) Name of the medication;
(iii) Method of administration;
(iv) Dosage;
(v) Frequency of administration;
(vi) Other special instructions, if any; and
(vii) Signature of the student’s parent or guardian.
If the written instruction is not consistent with the manufacturer’s guidelines for the nonprescription medication, the written instruction must also include a written order allowing the inconsistent administration signed by a prescriber.
(d) If the nonprescription medication is not approved by the Food and Drug Administration (FDA), a written order from the student’s prescriber is required and will include:
(i) Name of the student;
(ii) Name of the medication;
(iii) Dosage;
(iv) Method of administration;
(v) Frequency of administration;
(vi) A statement that the medication must be administered while the student is in school;
(vii) Other special instructions, if any; and
(viii) Signature of the prescriber.
b. A student being administered a medication may be monitored by designated personnel to monitor the student’s response to the medication;
c. A determination will be made by the district on if or when the student may self-carry prescription medication if the student has not been approved to self-administer medication;
d. It is the student’s parent or guardian’s responsibility to ensure that an adequate amount of medication is on hand at the school for the duration of the student’s need to take medication;
e. It is the student’s parent or guardian’s responsibility to ensure that the school is informed in writing of any changes in medication instructions;
f. In the event a student refuses medication, the parent or guardian will be notified immediately. No attempt will be made to administer medication to a student who refuses a medication;
g. Any error in administration of a medication will be reported to the parent or guardian immediately and documented on a medication administration record. Errors include, but are not limited to, administering medication to the wrong student, or administering the wrong medication, dose, frequency of administration or method of administration;
h. Medication shall not be administered until the necessary permission form and written instructions have been submitted and received as required by the district.
i. District personnel shall not recommend to a parent or legal guardian that the student seek a prescription for a medication that is prescribed with the intent of affecting or altering the thought process, mood, or behavior of the student.
j. District personnel shall not require a child to obtain a prescription for a substance covered by the Controlled Substances Act, 21 U.S.C. 801 et seq., as a condition of attending school, receiving an evaluation to determine eligibility for Section 504 of the Rehabilitation Act of 1973, early childhood education, or special education under ORS chapter 343 or receiving special education services.
7. Administration of Medication by a Student to Themselves
a. A student in grade K-12, including a student with asthma or severe allergies, may be permitted to administer prescription or nonprescription medication to themself without assistance from designated personnel, subject to the following:
(1) A student must demonstrate the ability, developmentally and behaviorally, to self-administer prescription medication and must have:
(a) The written permission from a parent or guardian and other documentation requested by the district must be submitted for self-medication of all prescription medications;
(b) If the student has asthma or a severe allergy, a medication that is prescribed by a prescriber and a written treatment plan developed by a prescriber or other Oregon licensed health care professional for managing of the student’s asthma, diabetes and/or severe allergy, and directs use by the student while the student is in school, at a school-sponsored activity, while under the supervision of school personnel, in a before-school or after-school care program on school-owned property and in transit to or from school or a school-sponsored activity. The prescriber will include acknowledgment that the student has been instructed in the correct and responsible use of the prescribed medication;
(c) The permission to self-administer the medication from a building administrator and a prescriber or registered nurse practicing in a district setting.
(2) A student must demonstrate the ability, developmentally and behaviorally, to self-administer nonprescription medication[6] and must have:
(a) The written permission of the student’s parent or guardian; and
(c) The permission of the building administrator and a prescriber or a registered nurse practicing in the school setting to self-administer medication.
(3) A student must demonstrate the ability, developmentally and behaviorally, to self-administer nonprescription medication that is not approved by the FDA and must have:
(a) The written permission of the student’s parent or guardian; and
(b) A written order from the student’s prescriber that includes:
(i) Name of the student;
(ii) Name of the medication;
(iii) Dosage;
(iv) Method of administration;
(v) Frequency of administration;
(vi) A statement that the medication must be administered while the student is in school, at a district-sponsored activity, under the supervision of district personnel, or in transit to or from school or district-sponsored activities;
(vii) Other special instructions, if any; and
(viii) Signature of the prescriber.
b. A determination will be made by the district on if or when the student may self-carry prescription medication if the student has not been approved to self-administer medication;
c. A student may have in their possession only the amount of medication needed for that school day, except for manufacturer’s packaging that contains multiple dosage, the student may carry one package, such as, but not limited to, autoinjectable epinephrine;
d. The sharing and/or borrowing by a student of any medication with another student is strictly prohibited[7];
e. Backup medication, if provided by a student’s parent or guardian, will be kept at the student’s school in a location to which the student has immediate access in the event the student has an asthma and/or severe allergy emergency;
f. A student shall not administer medication to themself until the necessary permission form and written instructions have been submitted as required by the district;
g. The permission for a student to administer medication to themself may be revoked if the student does not responsibly self-administer the medication or abuses the use of the medication as determined by district personnel;
h. A student may be subject to discipline, up to and including expulsion, as appropriate for violations of these procedures;
i. A student permitted to administer medication to themself may be monitored by designated personnel to monitor the student’s response to the medication;
j. The district allows the application of and use by students of nonprescription sunscreen, including sunscreen that contains para-aminobenzoic acid, without any required documentation from a licensed health care professional per ORS 339.874.
8. Handling, Monitoring and Safe Storage of Medication Supplies for Administration of Medication
a. Any medication must be delivered to the school in its original manufacturer’s or current prescription container, accompanied by the permission form and written instructions, as required above.
b. Prescription medication must always be the most current prescription and kept in the original, labeled container.
c. Nonprescription medication must be kept in original manufacturer’s bottle or box.
d. Never administer medication sent to school in unlabeled containers.
e. Never repackage medication into a plastic bag or other container for any reason.
f. Medication in any form categorized as a sedative, stimulant, anti-convulsive, narcotic analgesic or psychotropic medication will be counted or measured by designated personnel or parent or guardian in the presence of another district employee upon receipt, documented in the student’s medication administration record (MAR) and routinely monitored during storage and administration. Any discrepancies will be reported to the district nurse or principal immediately and documented in the student’s MAR. For such medication not in capsule or tablet form, standard measuring and monitoring procedures will apply.
g. Designated personnel will follow the written instructions of the prescriber and the student’s parent or guardian, and training elements as required by OAR 581-021-0037.
h. Medication will be accessible during emergency evacuations.
i. Designated personnel will be responsible for monitoring all medication supplies and for ensuring medication is secure at all times, not left unattended after administering, and the medication container is properly sealed and returned to storage.
j. When medication is running low or an inadequate dosage is on hand to administer the medication, the designated personnel will notify the student’s parent or guardian.
9. Emergency Response
a. Designated personnel will immediately call 911 or other appropriate emergency medical response systems and administer first aid, as necessary, in the event of life-threatening side effects and allergic reactions, including the administration of epinephrine. The parent or guardian, district nurse and principal will be notified immediately.
b. Adverse reactions which result from district-administered medication or from student self-medication will be reported to the parent or guardian immediately.
c. Any available district staff will immediately call 911 and the student’s parent or guardian if the designated personnel believes the student is experiencing symptoms of adrenal crisis and plans to administer medication.
d. Any available staff will immediately call 911 when a short-acting opioid antagonist is administered to any student or other individual on district premises.
e. Any available staff will immediately call 911 for any potentially life-threatening event, including if emergency medication or staff who are trained to administer emergency medication are not accessible.
10. Disposal of Medications
a. Medication not picked up by the student’s parent or guardian at the end of the school year will be disposed of by designated personnel.
11. Transcribing, Recording and Record Keeping
a. A medication administration record (MAR) will be maintained for each student administered medication by the district.
b. All records relating to administration of medications, including permissions and written instructions, will be maintained. Records will be retained in accordance with applicable provisions of OAR 166-400-0010(17) and OAR 166-400-0060(29).
c. All records relating to the training of designated district personnel will be maintained by the district in accordance with applicable provisions of OAR 166-400-0010.
d. Student health information will be kept confidential. Access shall be limited to those designated personnel authorized to administer medication to students, the student and their parent or guardian. Information may be shared with school personnel with a legitimate educational interest in the student or others authorized by the parent or guardian in writing or others as allowed under state and federal law.
Non-Liability Provisions for Administration of Prescription and Nonprescription Medications and Short-Acting Opioid Antagonists
A school administrator, teacher or other school employee designated by the school administrator is not liable in a criminal action or for civil damages as a result of the administration of nonprescription medication, if the school administrator, teacher or other school employee in good faith administers nonprescription medication to a student pursuant to written permission and instructions of the student’s parents or guardian.
A school administrator, teacher or other school employee designated by the school administrator is not liable in a criminal action or for civil damages as a result of the administration of prescription medication, if the school administrator, teacher or other school employee in compliance with the instructions of a physician, physician assistant, nurse practitioner, naturopathic physician or clinical nurse specialist, in good faith administers prescription medication to a student pursuant to written permission and instructions of the student’s parents or guardian.
A person may not maintain an action for injury, death or loss that results from acts or omissions of a school administrator, teacher or other school employee during the administration of a short-acting opioid antagonist unless it is alleged and proved by the complaining party that the school administrator, teacher or other school employee was grossly negligent in administering the short-acting opioid antagonist unless other conditions exist and which are outlined in Oregon law in ORS 339.870.
The civil and criminal immunities provided for above do not apply to an act or omission accounting to gross negligence or willful and wanton misconduct.
Non-Liability Provisions for Self-Administration and Autoinjectable Epinephrine
A school administrator, nurse practicing in the school setting, teacher or other school employee designated by the school administrator is not liable in a criminal action or for civil damages as a result of a student’s self-administration of medication, as described in ORS 339.866, if they, in compliance with the instructions of the student’s Oregon licensed health care professional, in good faith assist the student’s self-administration of the medication, if the medication is available to the student pursuant to written permission and instructions of the student’s parent, guardian or Oregon licensed health care professional.
A school administrator, nurse practicing in the school setting, teacher or other school employee designated by the school administrator is not liable in a criminal action or for civil damages as a result of the use of medication if they in good faith administer autoinjectable epinephrine to a student or other individual with a severe allergy who is unable to self-administer the medication regardless of whether the student or individual has a prescription for epinephrine.
The district and the members of the school board are not liable in a criminal action or for civil damages as a result of the use of medication if any person in good faith administers autoinjectable epinephrine to a student or other individual with a severe allergy who is unable to self-administer the medication, regardless of whether the student or individual has a prescription for epinephrine; and the person administered the autoinjectable epinephrine on school premises, including at a school, on school property under the jurisdiction of the district or at an activity under the jurisdiction of the district.
The civil and criminal immunities described above, which are identified in ORS 339.871, do not apply to an act or omission to gross negligence or willful and wanton misconduct.
[1] There are several laws that apply to medications in schools. Some of these laws have unique definitions that may apply in specific situations. If the applicable law uses a definition that varies from the definition here, use the definition in the law.
[2] A registered nurse who is employed by a district or local public health authority to provide nursing services at a district may accept an order from a physician licensed to practice medicine or osteopathy in another state or territory of the U.S. if the order is related to the care or treatment of a student who has been enrolled at the district for not more than 90 days.
[3] An online training may qualify as “in-person” when these measures are met: content is provided via synchronous, interactive online sessions with a trainer and learners visible on screen; trainers must be licensed and work within their scope of practice; and include in-person, skills demonstration for training developed by the Oregon Health Authority for epinephrine, glucagon, and for medication to treat adrenal insufficiency.
[4] Including district personnel who have not received medication administration training
[5] For nonprescription medication that is not approved by the Food and Drug Administration (FDA), see requirements in 6.a.(2)(d).
[6] For nonprescription medication that is not approved by the Food and Drug Administration (FDA), see requirements in 7.a.(3).
[7] Except for short-acting opioid antagonists.