Section 071-40-2 - ADMINISTERING MEDICATIONS IN A SCHOOL SETTINGA. The school nurse will provide direction and oversight for the administration of medication in the school.B. School nurses are responsible for their own actions in the administration of medication. It is the school nurse's responsibility to clarify any medication order which he or she believes to be inappropriate or ambiguous. The school nurse has the right and responsibility to decline to administer a medication if he/she believes it jeopardizes student safety. In this case, the nurse must notify the parent, the student's health care provider and the school administrator.C. Any public or private school approved shall have a written, local policy for administering medication. [20-A MRSA § 2902; 20-A MRSA § 4502 ] The policy must include the following: i. All unlicensed school personnel who administer medication must be trained before receiving authorization to do so.ii. Before medication is administered to a student there must be:1. A current written request from the parent for any medication administered to a student during school or a school sponsored event. Verbal permission may be used if needed due to extenuating circumstances. For this purpose, explicit verbal permission from the parent must include the medication requested, dose, route, and time interval to be given. This is to be documented in the student health record and valid for one day only.2. A current written order from the prescribing health care provider for any medication administered at school. The order must include the student's name, the name of the medication, the dose, the route of administration, time intervals to be given, any special instructions, and the name of the prescribing licensed health care provider. A medication label that provides sufficient information may be used in lieu of a written order unless the medication is to be administered for more than 15 consecutive days.3. Written parental permission forms and physician orders must be renewed at least annually. Physician orders must be renewed if there are changes in the order.iii. It is recommended that the first dose of a newly prescribed medication be given at home. The exception will be the use of epinephrine autoinjector for an unknown anaphylaxis, or emergency medication for diabetes such as, but not limited to glucagon or other life-saving medication.iv. The medication must be delivered to school in its original container, properly labeled.v. Students may possess and self-administer emergency medication of an inhaled asthma medication, an epinephrine auto-injector, or medications related to the care of insulin dependent diabetes, under the following conditions: 1. Written approval is received from the student's health care provider stating that the student has the knowledge and skills to safely possess and use an inhaled asthma medication, epinephrine auto-injector, or other medication related to the care of their insulin dependent diabetes. a. An Individualized Health Plan and Emergency Plan for anaphylaxis is needed for those with epinephrine autoinjectors.b. An Individualized Health Plan and Emergency Plan is needed for those students with asthma requiring treatment and management at school.c. An Individualized Health Plan and Emergency Plan is needed for those students with diabetes requiring treatment and management at school.2. Written approval is received from the parent indicating that their child may carry and self-administer the medication.3. The student demonstrates to the school nurse their ability to carry and use the inhaled asthma medication, epinephrine auto-injector, or medication related to the care of their insulin dependent diabetes properly and responsibly. The school nurse should consider the ability of the student to understand their diagnosis, appreciate the importance of taking their medication at the right time and in the right amount, and accept the responsibility that comes with self-carry medications.4. Recognizing that there are many unique medical needs of children. If it is determined within the Individualized Health Plan that self-carrying a specific medication not previously addressed in this rule is necessary, a school nurse may allow it so long as the conditions in 1-3 are met.vi. Students may possess and self-administer topical sunscreen without a signed order from a health care provider under the following conditions:1. Sunscreen is to be in its original container, labeled with directions of use and warnings.2. Written permission from parent as required by Section 2 C (ii)(1).3. School nurse or other school personnel may inspect sunscreen product for safety and proper FDA labeling.4. There is no expectation that school staff will apply sunscreen to students.5. There is no expectation that the school will supply sunscreen to all students.6. A student who is unable to physically apply sunscreen may be assisted by school personnel when directed to do so by the student, if permitted by a parent or guardian and authorized by the school.7. It is recommended that aerosol or spray sunscreen not be used in schools because it could adversely affect students with asthma and/or allergies.D. Procedures/protocols for medication must be developed for:i. How medications are to be safely transported to and from school.ii. Medication administered on field trips and other off campus activities that is in compliance with section 4 of this rule.iii. Accountability of medications, particularly those regulated by the Federal Narcotics Act.iv. The proper storage of medication at school.v. The training of appropriate staff on administration of emergency medications including the detailed standards for the signs and symptoms of anaphylaxis and the use of epinephrine autoinjector for previously unknown severe allergies. vi. The procedure to use should a medication reaction occur.vii. Access to medications in case of a disaster.viii. The process for documenting medications given and medication errors.ix. The proper disposal of medications not retrieved by the parents.E. Within school administrative units or approved private school personnel shall follow the guidelines for the stocking and administration of epinephrine autoinjectors as outlined in section 5 of this rule. [20-A MRSA § 6305 (1-9)]F. School administrative units or approved private schools may develop policy and protocol for Naloxone as outlined in Section 6 of this rule. [20-A MRSA § 6307 ]G. Reasonable accommodations must be made for students who hold written certification for the medical use of non-smokeable marijuana under Title 22, section 2423- B. [20-A MRSA § 6306 ] For the purposes of this rule cannabidiol (CBD) oil is a marijuana product and subject to the same limitations. Medical marijuana may only be possessed and administered under the following conditions: i. The student requires a dose during the school day.ii. It is possessed by the parent/guardian or caregiver only.iii. Only the parent/guardian or caregiver may administer medical marijuana - it cannot be done by, or delegated to, a school employee or any other person than the primary caregiver.05-071 C.M.R. ch. 40, § 2